HOSPITAL DRIVE - News - University of Virginia
Transcription
HOSPITAL DRIVE - News - University of Virginia
Anthology HOSPITAL DRIVE A literature and humanities journal of the UVA School of Medicine Featuring “Formation of Identity” Contest Winners Anthology & Formation of Identity Contest Word. Sound. Image. This anthology is our editors’ choice of work published since the first edition of Hospital Drive in 2007, and is our first print edition. We have been publishing the creative work of poets, patients, nurses, doctors, physical therapists, prose-writers, artists, photographers, and more since we were founded by Danny Becker as the online literary and humanities journal of the University of Virginia School of Medicine. We publish original literature and art from around the world on themes of health, illness, and healing. Hospital Drive is the name of an actual road at the University of Virginia. Set between Thomas Jefferson’s original academic village and the earliest buildings of the School of Medicine, it brings visitors into a community of scholars, teachers, healers, artists, and the people they serve. For our first-ever poetry and prose contest, we sought submissions that explore the idea of “Identity” within the context of health—words that would change the way we think about who we are. For more on the story behind our curiosity about Identity formation, please see the interview with Danny Becker. This edition is also available on our website. We would like to acknowledge the support of Sharon Hostler, Joan Klein, Addeane Caelleigh, Matt Goodman, Mary Beth Meachum-Whitehill, Ray Nedzel, and of the University of Virginia School of Medicine. Special thanks to Richard Shannon, Executive Vice President for Health Affairs at the University of Virginia, who is both a supporter and reader of Hospital Drive. Without his help there would not be a print edition. 1 HOSPITAL DRIVE A literature and humanities journal of the UVA School of Medicine Editor: Paul Shepherd Poetry & Founding Editor: Daniel M. Becker Prose Editor: Linda Kobert Managing Editor: Carrie Gumm Editorial Staff: Ambika Babbar, Ashley Davis, Charlotte Heppner, Colin Hill, Dan Luftig, Alice Meiss, Olivia Quach, Sarah Schall, Amanda St. Ivany, Christa Tabacaru, Lexie Lulu Wang, Annelise Wilhite, Hui Zhao Designer: Branner Graphic Design To find out more about Hospital Drive or to order a copy, please contact us: University of Virginia, School of Medicine, PO Box 800758, Charlottesville, VA 22908 Email: [email protected] Cover: UVA Archives ISBN 978-0-692-62799-0 © 2016 University of Virginia, School of Medicine All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means without permission in writing from the editors. All statements of opinion or fact are the responsibility of the author alone and not of Hospital Drive, the University of Virginia, or the School of Medicine. news.med.virginia.edu/hospitaldrive 2 Editor’s Forward I’m beside my wife’s bed at Butterworth Hospital in Grand Rapids, Michigan. She’s still out cold from the surgery. A few hours ago, she donated a kidney to a boy, a distant relative, and I know she’s going to be nauseous, disoriented, and she’d rather not have the television on when she comes around. Still, if I can keep the volume low, I can catch a little news. It’s boring, after all, and trying to read or work in a hospital room is about as much fun as sorting socks. She opens her eyes just as Obama is delivering the eulogy in Charleston for Clementa Pinckney. We can barely hear—then she asks me to turn it up, because he’s just started singing Amazing Grace. It’s the one thing she’ll remember from this day, over the soreness and incessant nausea. Over the next few days, we get to know one of the nurses’ aides—an orderly, we used to say—very well. He’s quite young, but there’s a way he has of checking on her that’s a bright spot in the long hours. We learn that he’s applying to medical school, and working here so that he can get some real-life experience. “You’re going to be a good doctor,” she tells him. He’s got that reassuring mix of gentleness and confidence, but it’s more than that— he’s signed on for the journey with her, he’s with us. Doctors, nurses, therapists, medics have access to places in our bodies, minds, and souls that we don’t even know ourselves. It’s easy sometimes to see problems in these places as problems to be solved—and indeed they are. Incisions are done right. The medicines are dripping on schedule. When my wife first sits, then stands, then walks to the bathroom (and the hated catheter is finally removed), it’s all according to plan. We’re often awed by this machinery of medicine, but the real wonder is in the comforts of kindness, in a question that opens the heart, and in the ability of each person involved to look past easy solutions and into meaningful connections. These pages give voice to this sense of wonder. Bringing inspiration and imagination to the page means bringing inspiration and imagination to the patient. In the way masterful musicians find the music not in playing the correct notes, but in seeing what is hidden in them, masterful healers seek to see through the equations and diagnoses and careful incisions to stand humbly before the mystery of healing itself. In these pages—in the pouring-out of who we are—we acknowledge that we are reaching for that moment we don’t always understand. Within the suffering and healing, sometimes a song breaks out—or a poem, or story, or painting—to remind us that even in sterile rooms, we have a deep need for grace, humility, and to celebrate the human spirit that endures. —PS 3 Sherborne Abbey Organ Mother at 92 A Little Soul The New Patient Lance Buckley • 52 Harrison O’Connor • 73 Eleanor Leonne Bennett • 93 Susan Okie • 102 First Session My gift was guessing John Krumberger • 54 John Casey • 74 Why I Never Went to College Dr. Who Overshoots the 60s Kids at Art Carol Baldwin • 96 Lance Buckley • 103 Rebecca Previs • 41 God Lives on Brown’s Mountain Rosey Fingered Dawn The Distance Ratio Rotunda Lady Harrison O’Connor • 55 Thomas Wright • 97 Elizabeth Maria Naranjo • 104 NYC Parking Contributer’s Biographies Murry Whitehill • 98 Art, Poetry, Prose • 109 Of Time and the Beauty Contest New Rothko Contents At the Met Baby in the Closet Elizabeth Meade Howard • 6 Marianna Crane • 15 Listening to a Patient with ALS The Carver Barbara Brooks • 7 Autumn Leaves Jim Hagan • 8 Allure and Cure Sandra Lapham • 8 Grandma-Sitting Will Clemens • 10 Driving with My Grandpa Johanna Shapiro • 20 Circles Mary Richardson Miller • 21 Old Gleason Jim Hagan • 22 Cowboy Bar Suppertime at the Nursing Home Harrison O’Connor • 11 Barry W. North • 24 Seeing Yo-Yo Ma with the Dayton Philharmonic Will Clemens • 12 Phantom Pains Courtney Hartnett • 13 Crayon Drawing Sharon Hostler • 14 4 Murray Whitehill • 19 Harts Pass Fire Slope John Voss • 26 Harm’s Way Tim Kelly • 27 LET X=Y-2 Tim Kelly • 28 Morman Motorcyclist Discusses Chapter One of the Tao Te Ching as I Mobilize His Surgically Wired-Together Wrist Tim Kelly • 29 Interview with Founding Editor, Dr. Daniel M. Becker Olivia Quach • 30 Home Visit Daniel M. Becker • 35 Blossom Houdini Medicine Dianne Nelson Oberhansly • 36 Water for All Eleanor Leonne Bennett • 37 Doctor Lee Dave Morrison • 38 Quality of Life Anjali Jain • 39 Dr. A Surgery Murray Whitehill • 40 The World’s Shortest Medical Student Stories: Life. Death. Survival. Healing. Bobbye Cohen • 44 How to be an ER Nurse Kristin Laurel • 45 A Drunk in the ER Queen’s Barge Lance Buckley • 56 Consent for a Laryngectomy Kristin Laurel • 48 Renée Rossi • 58 Sea Turtle & Scuba Diver Work & Family Teresa Guise • 49 Steve Cushman • 61 Gravity Smith Surgery Kathleen Cain • 50 Murray Whitehill • 61 Equinox A Surgeon’s Geography Graham Fulton • 51 Martha Kaplan • 62 Underwater Stroll Fireflies Lance Buckley • 51 Michael Adams • 63 Murray Whitehill • 76 Art at the High Lance Buckley • 78 Our Urologist Kendra Kopelke • 79 Pointing The Finger Kendra Kopelke • 80 Sunset Mountain Kenneth Weinberg • 113 Dan Sklar • 100 Sea Turtle Teresa Guise • 101 Armando Huaringa • 82 Tweaking Fate Marsha Roberts • 83 Paysaten Thistle Congratulations to our Formation of Identity contest winners and finalists: John Voss • 90 Swimming Lessons • 23 Beverly Magovern Lyon Film Noir • 77 Laura Foley 4:45 At the Assisted Living Facility • 53 Michael Harty The Wishing Stone • 94 Cecily Markham He Was Henry Hudson • 64 Linda Chase Here’s the Dream • 99 Monica Wendel Dirty Poet • 92 5 Barbara Brooks Listening to a Patient with ALS It started in my left foot, it’s the worst one right now. I don’t want to get stiff, don’t want a feeding tube, I want to eat like I always do. I’ve researched this disease— it’s stealing my body. What about your other patients— the young woman— does she have children? And the one who can’t hold her head up. You know, you can’t see the wind, or a word or love. I wonder if you become energy. I want to have control at the end. I think the light people see is just the brain shutting down. One week I can get in the tub, the next, I have to figure a new way. LEFT: At the Met Elizabeth Meade Howard 6 7 Sandra Lapham Allure and Cure TRIGGERS “I haven’t had a drink since December 12,” he said proudly. “Liquor stores I can deal with. But every time the bus goes by that 7-Eleven, I see that place in the cooler where my favorite beer sits, waiting. It haunts me; I haven’t figured out a way around it.” JUST ASKING I was telephoning them ten years after their first interview, to ask for their participation in a follow-up study of impaired-driving offenders. “Sure, I remember that interview,” she said kindly. “That was the day I stopped drinking.” MUG SHOT She had so many arrests the bondsman got to know her. After many years she quit drinking. When she saved enough to pay her debt, she visited him again. He smiled and, against the rules, presented her last mug shot. “You can have it,” he said, “you don’t have to look like that no more.” 8 THE URGE “That medication you gave me worked,” he blurted at his next office visit. “I didn’t feel drunk even after 12 beers.” THE LOOK She had a broken wrist one month, a swollen face the next. Fell down the stairs? Accident at the gym? “The medication was intended to stop your craving so you wouldn’t want to drink, not to prevent you from getting drunk,” I said. I met him at a party—he had been drinking. His glower surprised and scared me. I ended the innocuous discourse abruptly. I knew. “Yea, I know, but I was curious,” he demurred. SAY WHAT? She hadn’t had a drink since starting the medication. TIT FOR TAT My patient, a repeat offender, finally quit drinking. “Great,” I said. “How did you do it?” “A drunk driver crashed into my car,” she said. LUCKY THUMP Margie could put away ten shots of tequila and twenty beers in a sitting. One such night, she tumbled down a flight of stairs, striking her head hard, and woke up. She hasn’t had a drink since. “I want to quit the study,” she announced. “Why?” “I don’t need to drink any more. Even with alcohol in the house, my urges to drink are gone.” “Do you think it’s the medication?” “Yes!” “Then why stop taking it?” “Oh.” FAR LEFT: Autumn Leaves Jim Hagan 9 Will Clemens Grandma-Sitting The morning weatherman on Channel 5 in Cincinnati said a sudden drop in pressure might cause road rage on the highways. The State Patrol got wind of that I guess. Each median to Dayton had a cop car. I calmed myself with Appalachian Spring until the station faded on the back roads and the smell of pigs came through my tilted moonroof. I turned off Stoneybrook onto the limestone lane which fits in my parents’ front lawn like a spine. The south lawn stretches to the neighbors’ brook. The north lawn edges to the nursing home, where Grandma stayed a week that spring with chest pains. Mom and Dad were off to rent her home in Louisville. I came to Grandma-sit. 10 They met me at the front door by the floor clock, Handel’s quarters chiming with hellos, the striking almost muting our goodbyes. With the tenth and final strike still lingering like dust behind the Buick driving off, my chubby grandma shuffled down the hall, her purring calico in figure eights around her swollen shins and walker legs. She plopped down in her chair at the breakfast table. “Down went McGinty to the bottom of the sea,” she said and licked her lips as I began to cut into the cooling streuselkuchen. “See that?” she asked and nodded toward the window to the goldfinch in the pear out back. “That’s where you get on board for Mars.” “Oh, right,” I said and smiled. She meant the tower that stood beyond the pear tree like a rocket. Dad had tested it out there and planned to put it up in Cedar Bog Preserve to gauge what smog from sprawl could reach the bog. The goldfinch flew off suddenly. “Look there!” I whispered, pointing to some moving leaves in underbrush cut back from the yard. I thought that deer would spring from them; instead, two old men, AWOL from the nursing home, emerged and sipped at something from a flask. They waddled to the tower, rubbed their chins, and disappeared like Martians through the brush. Cowboy Bar Harrison O’Connor 11 12 Will Clemens Courtney Hartnett Seeing Yo-Yo Ma with the Dayton Philharmonic Phantom Pains Outside my Honda, under my umbrella, Dad took my elbow like a wizard’s wand to move the curbs and puddles from our path. Indoors, the marble floor was slick with drops, but Dad, his view eclipsed by retinitis, wore his rubber-soled Bostonians, my arm a guide wire to our seats, where silence shaped the tuning to a cough and whisper. The sudden tapping of the maestro’s steps across the stage echoed with applause. He said, “The good news is the Ark is here; the bad news is there’s only room for two of us.” We laughed. He led the way into The New World. Dvořák’s ode to Spillville, Iowa, Hanging out clothes on a hot July evening, my mother told me stories. The ones I remembered were gave Ma a chance to rock like Brother Ray. The rondo boomed into a standing O. Ma calmed us down and said that he would play a solo piece called “Appalachia Waltz,” with Maestro on Tai Chi. Dad couldn’t see the maestro’s pushing hands or yin-yang feet but could have imaged them from Navy days in Hong Kong when his retinas were lit like Chinese lanterns, soon to flicker out. Along the street, that bluegrass in our heads, Dad’s fingers on my arm to Wu-Li dance across the rain-swept parking lot, he says, “That concert was the best I’ve ever seen.” about my great grandmother, the one with only one leg. They rode in her wheelchair while she slept: the fence of one is the freedom of another. She didn’t talk about the leg she lost; like a gone family member, everyone knew what had happened. Sometimes, though, she would sit quietly, when the crickets sang at night and everyone else slept under the starpricked blanket of sky, and feel the swirling fields of pain settle where there was nothing: an ankle throbbed, a calf spasmed, a knee pulsed and twitched as the pains reached with blind fingers, searching for what was lost. 13 Marianna Crane Baby in the Closet Crayon Drawing Sharon Hostler 14 I heard the soft hum of oxygen flowing into a tented crib as I made my way down the corridor of the pediatric unit. From another room, a child barked a wet cough. I stopped in front of the linen closet and flicked on my flashlight. I opened the door. The beam of light skimmed shelves stacked with crib sheets, blankets, and rubber mats before finally shining on the small bump covered by a blue blanket in an isolette. The blanket rose and fell with each baby breath. That’s all I needed to see. I snapped off the flashlight and shut the door. The baby was still alive. It was the summer of 1963. I had just turned twenty-one that May. After graduating from nursing school the previous fall, Gloria, my nursing school roommate and long-time friend, and I had quit our full-time positions. We rented a beach house down the Jersey Shore. Our goal was to find part-time jobs, party on our nights off, and doze on the sand during the day. Once the summer was over, we planned to move to San Francisco. Outside our work environment, where we wore white uniforms and a professional demeanor, we shared an immaturity and hunger for a free-spirited lifestyle. There were two night-shift positions at the community hospital. We tossed a coin. Gloria won. She got surgery. I ended up in the pediatric unit. That night when I arrived to start my shift, the evening nurse was sitting at the desk in the nursing station. Middle-aged, she wore her dark hair pulled back in a low bun at the nape of her neck. Usually busy with last-minute charting, this time she watched my approach in silence. I pulled up a chair. The blanket rose In a soft voice she began the ritual and fell with each of giving report: “Room 400, bed one, baby breath. That’s two-year-old for observation after a all I needed to see. television set fell on his head. He’s been fine. Going home tomorrow. Bed two, seven-year-old scheduled for a tonsillectomy.” She finished with room 410, a private room, which held an eighteen-month-old who had intermittent spiking fevers. Thinking she was done with her report, I got up from my chair. “Wait,” she said. I eased back down. “There’s a newborn in the linen closet at the end of the hall. He was born with spina 15 bifida. The parents were told he couldn’t live with his deformities.” Her voice became softer. I leaned in to hear. “Just notify the nursing supervisor when he dies.” I felt my chest constrict. A baby being left to die? This didn’t sound right. But the evening nurse had already risen as if to ward off any questions. She headed to the chart rack, pulled out a chair, sat down, selected a chart, flipped it open, and began to write. “Oh yes,” she said over her shoulder. “The night supervisor knows you have a full house. Call her if you need anything.” Once the evening nurse left, I changed into sneakers. They were quieter than my nursing shoes and helped me race in and out of the rooms if I became busy. “I go home and give Then I took off my cap, the hallmark my kids a big hug. of my status as a registered nurse. It Then I thank the good would fall off anyway when I stuck Lord they’re healthy.” my head inside an oxygen tent. The night supervisor endeared herself to me, because when she made rounds on my floor she never reprimanded me for my sneakers or my bare head. I braced myself for a hectic shift. Parents weren’t around to help or hinder since hospital policy prohibited their staying overnight. My nurse’s aide, Hattie, and I monitored our charges from midnight to dawn. I kept an eye on the sickest patients, dispensed medications, changed dressings, checked oxygen tanks, and counted the drops flowing from intravenous fluids. Hattie took temperatures, changed diapers, and fed the babies. Each room had a rocking chair for this purpose. 16 I found Hattie in the clean utility room. The acrid odor of alcohol drifted from two glass containers on top of the steel cart, one for each used oral or rectal thermometer. Clean diapers, washcloths, towels, and extra sheets were crammed onto the bottom shelf. An empty garbage bag hung off one side of the cart, and a cloth laundry bag for soiled linen hung off the other. “No need to do anything for the baby in the linen closet,” I said, handing her the list of patients that would need temperatures taken. “I’ll check on him.” Hattie’s pale pink uniform set off her dark skin. Her normally smiling face took on a solemn cast. What else could I say? I was told to monitor the baby and tell the supervisor when the baby died. I would follow orders. Hattie and I were a good team. A few years older than me, she had worked on the pediatric unit for the past three years. “How can you deal with sick children all the time?” I had asked her on one of our first nights together. “I go home and give my kids a big hug. Then I thank the good Lord they’re healthy,” she said. Well, I had no children to go home to. And I had no intention of staying at this job. After I went off duty, it was all I could do not to replay the images of the sad, weeping children alone in their cribs. I began my rounds, slipping quietly into the rooms, shining my flashlight on sleeping bodies. The two-year-old injured by a fallen TV woke. He pulled himself up. The bandage wrapped around his head had slid down over his eyes. “Mommy,” he called, stretching his arms through the crib railing. I lifted him out, straightened the white gauze turban, and rocked him. From my peripheral vision I watched Hattie tiptoe into the room. She handed me a sheet of paper. “This is the only elevation,” she said as she aimed her flashlight on the paper so I could read her report. “Damn,” I said under my breath. The eighteen-monthold with fever of unknown origin had a high temperature. “Sorry,” I whispered to the boy in my lap. “I have to go now.” I lowered him back into his crib. He clung to my uniform. I pried open his fists. His sobs followed me as I headed down the hall to the clean utility room to grab towels, a basin of cold water, and a rubber mat. I closed the door to the private room behind me and snapped on the lights. The feverish boy sat in his crib, his arms limp by his side, his face flushed. His glassy eyes followed my movements. I hummed as I placed the mat on the inside of the crib. Setting the basin on the bedside table, I proceeded to soak two towels, one at a time, in the cold water, wringing them out and placing them on the mat. Soon I had the boy undressed and wrapped in the wet towels. A dry towel encased him, holding in the moisture. I placed him on my lap, which was covered with the rubber mat to protect my uniform from getting soaked. His weak cry reached some primal place deep inside me. Tears dripped down my cheeks as I rocked. I remembered my student rotation in pediatrics. I felt helpless when I couldn’t take away pain or discomfort from the babies or children assigned to me. I had vowed then never to work in pediatrics. I had to remind myself if it weren’t for the job, I wouldn’t be able to rent the beach house, cultivate the perfect tan, or go to bars to His weak cry reached some meet boys. primal place deep inside Finally the baby’s fever me. Tears dripped down my broke. I dressed him in a cheeks as I rocked. dry diaper and undershirt and left him asleep in his crib. I dropped off the basin, towels, and rubber mat in the soiled utility room and began to check my patients again. I started at the end of the hall and cracked the door open to the linen closet. My flashlight illuminated the isolette, a simple crate-like box with clear plastic sides that held a small mattress. Isolettes were used to move babies from the delivery room to the nursery where they were washed, swaddled, and taken into the mothers’ rooms for cooing and cuddling. This baby’s isolette had traveled from the delivery room directly to the closet. Where were the parents now? What were they thinking? Did they even know that their baby was stored in a linen closet? Staring into the isolette, I prayed. Please let the baby be alive. Don’t let him die on my shift. The blanket moved. The baby was breathing. Relieved, I closed the door and continued rounds. 17 Toward the end of our shift, Hattie and I marched down the corridor, brightened by the rising sun, to prep a child scheduled for surgery. I carried a tray with two hypodermic syringes: one filled with a sedative and the other with a drug to prevent bradycardia, an abnormally slow heart rate that can occur with laryngeal stimulation during surgery. The bed sheet had twisted around the ten-year-old girl’s long thin body. She jerked when we approached the bed. In a second she sprung up from the mattress, her eyes riveted on the syringes. Having had multiple skin graft operations in the past, she knew what was coming. She bounced on bare legs covered with pits and I was told to notify the night valleys like craters on the supervisor when he dies. moon from scar tissue caused by severe burns. No amount of pleading would entice her to hold still. Finally, Hattie and I succeeded in encircling her in a sheet, leaving her right arm out for me to inject. I left the room in a sweat. Hattie stayed behind to comfort, wash, and dress the girl in a clean hospital gown. Soon the day shift arrived: two nurses and two aides. A few minutes later, the head nurse lumbered into the nurses’ station. She took down the plastic hatbox stored on the shelf in the coat closet and lifted out a white cupcake cap. When she emerged from the nurses’ bathroom, the cap was secured with a bobby pin to the top of her head. Then she lowered her heavy haunches onto one of the stools by the 18 counter where I waited in my nursing shoes, cap on my head: professional and deceptively unfrazzled. I reported on the condition of each of the twenty-one patients Hattie and I had cared for during the night. “There’s more,” I said as she started to rise. I told her about the baby in the closet. I tried not to show emotion, but my voice cracked when I continued. “I was told to notify the night supervisor when he dies.” The head nurse raised her squinty eyes to my face. I paused for a second to control my emotions. By God she was not going to see me cry. I forced out each word in staccato rhythm: “He is still alive.” The head nurse gathered her notes, pushed herself up from the stool, glanced at the paper stack in the wire bin on the counter, and said, “You haven’t finished filing the lab reports.” While I pasted each report in its respective chart, I tried to figure out why the head nurse seemed to dislike me. She never criticized my nursing care, but then she never told me I was doing a good job either. I decided, in my egotistical way, that she was jealous of my youth, freedom, and thinness. Then I thought of Gloria sitting in the visitors’ lounge at the end of the hall. She always got off on time and waited for me so we could drive home together. This morning she would have to wait longer than usual. I filed the last report and tramped off the unit, slowing down as I passed the linen closet. I was off for the next two days. Chances were the baby would have died by the time I returned. Gloria leaned against the doorframe to the patient lounge. Snatching her tanned arm, I pulled her toward the stairs, anxious to leave the hospital and put this night behind me. That was decades ago. I have since raised two children of my own, built a career, and moved several times. Now, during the serene days of retirement, I babysit regularly for my daughter’s children. When she placed my first grandson on my chest and covered him with a blue blanket, I closed my eyes and felt his breath soft on my cheek. While we rocked, my mind wandered back to the dim pediatric corridor. Fragments of memories, long buried, began to surface. I see myself young, thin, and tan, dressed in a starched white uniform. I am walking down the hall of the pediatric unit. The breathing of my young charges floats from patient rooms. At the end of the hall I stop in front of the door to the linen closet—a door I have kept closed for almost fifty years. I clutch the knob, turn, and push the door open. I flick on my flashlight. The beam illuminates an isolette. Inside, the blue blanket rises and falls. But instead of quickly closing the door, I watch myself place the flashlight on the shelf and lift the baby into my arms. The Carver Murray Whitehill 19 20 Johanna Shapiro Mary Richardson Miller Driving with My Grandpa Circles After my grandpa stopped being a big city surgeon he moved to the Ozarks and became a country doc how to tip a cow Mostly the radio blared twangy tunes or hell-fire preaching which also brought back the smile feeding her men and her pigs, sweeping that floor till the cancer ate her face and there was nothing left When we visited, my brother and sister stayed back to eat pancakes play dirtball or catch fireflies One time he drove farther out than I’d ever been The house was just two rooms a dirt floor, no electricity I remember she had no face But I remember more the way my grandpa caressed where her cheek had been I went with grandpa in his rickety, rattletrap car driving along bumpy, unpaved roads that seemed relentless In the bed was a woman with no face Skin cancer, my grandpa said This didn’t need to happen, he said Grandpa didn’t say much He had a small smile that showed up when he asked me if I knew She never sought out care until it was far too late She was too proud and too poor She worked too hard The ruby ring of the desk clerk winks as his fingers force-feed a machine rapping out my life in long lines, and the TV hums with General Hospital and one woman talks to another about needlepoint, the way women do, and I sit waiting to be tested, surrounded by sick people, some sleeping with x-rays cradled in stick arms, while I read the saga of a poet, and soaps give way to Divorce Court, then I pick up a pen in defense, scribbling my own saga then stop to stare at the back of a woman combing her rust-colored hair, wavy like a corrugated roof, and I wonder when she dies will her family clip a curl or two, or torch it with the rest of her, and I try not to feel, happy to be harping on pen in hand—focus dammit!—bliss blown as I bolt to another room where more pale people wait drinking apple juice to blast the taste of fleet-phospho soda, and a woman walks by wearing a navy wool cap, the kind longshoremen wear in winter, not here in the tropics at eighty degrees, and exotic patients circle with maps, and a pretty young doctor whirls by visibly in need of a nap, and the woman with rust hair arrives reading a prayer book, and the sewing ladies arrive clutching their needlepoint, all of us circling, revolving in and out of waiting rooms, longing for kindness, for comfort, a doctor, anyone, and I return to the poet who urges me to stand like a firm tower that never shakes in the wind, and finally, we descend into this comedy of errors in the cold corridors, and now it’s so late people are saying goodnight and I still haven’t seen a doctor and we are all disoriented, disheveled, and I know Dante would circle with us while someone somewhere decides which door we’ll enter and when. 21 Formation of Identity contest winner—Poetry Beverly Magovern Lyon Swimming Lessons Would it have made a difference if I had arrived in a later season, say, spring 1945 or fall of ‘53? Would my mother have learned to float by then, confident and tan? Suppose my grandmother had not stepped out for a smoke, but had stayed at her station sorting the Red Delicious, would she have spotted the auburn-haired sailor with tattoos and a bit of mischief? She called him Red. He called her Dot. Would she still have been a mother at fifteen? If her own mother, my great grandmother, had not set her adrift among a sea of wimples in an orphanage cleaning endless octagonal tiles with a frayed toothbrush, would my grandmother have learned somewhere the buoyancy of love? Old Gleason Jim Hagan 22 And if my great-great grandfather, a fisherman with chapped hands and a salt-licked face, had not left his wife with a splintered boat and four daughters to raise, would she still have pawned off the eldest to the first man in town who walked on land? Would it have mattered if that fisherman had learned to swim? Would I be drowning now? This poem should be required reading at life guard school. The first rule at life guard school? Don’t drown. I teach that rule to my patients who are caregivers and slowly learning that not everyone can be rescued. It’s also worth teaching to everyone who rescues or harbors rescue fantasies. —DB 23 Barry W. North Suppertime at the Nursing Home Every evening at 5:30 I do what I’ve dreamed of doing for years. I leave my past behind and start anew, even though it is not exactly the way I imagined it. I have not moved to a scenic little burg in Mississippi. I am not living above the only bar in town. The feisty little redhead pushing drinks down below, her ass twitching like an invitation everybody in the joint thinks is addressed to him, is not enthralled with the aura of mystery surrounding me. Her ten-year-old son has not taken to calling me dad. I am not sailing novels out of my window, like paper airplanes, which land, more often than not, on The New York Times Bestseller List. (Although, I must admit, my old dreams have been hanging around lately, looking like long departed relatives, somebody up there breathed life back into.) When I see the mayor he does not, in deference, tip his hat to me. 24 This is because I did not, while everyone looked on, pull his useless alcoholic son out of his brand new Mustang, which was slowly sinking to the bottom of that thirty-foot deep canal directly across from the bar. Indeed, if the truth must be told, I am no hero at all. In fact, I have never done a single heroic deed worth mentioning. But when I cross that threshold at suppertime, I swear I grow a foot. To the beat up, worn out residents in their wheelchairs, I am more powerful than a locomotive. They would not be surprised to learn that yesterday I leapt a tall building in a single bound. I wheel them in and out of the dining room. I smile; I hold their hands; I stroke their faces; I listen to their gibberish. The small kindnesses I offer they accept, like enormous checks written out in their names, which they cash and give me the money. 25 Tim Kelly Harm’s Way Every street, every field, every fishbone, every baby carriage wheeled through a Saturday Market ticking; every barbeque finger-licking. Every tock, every tick, every vaccinating needle, every prick you ever dated, every rash, however belated, that itched? You are hitched to Harm like a mule, girl, humbled, tumbled from your antiseptic throne, and driven by Harm past the bone- yard, his subs throbbing the street, thumping your eardrums, twigging the trees. Why not be sweet? says he. They’re digging folks new digs here daily, baby. Yet the world seems to shiver with beauty and good cheer. Even acknowledging every factoryslaughtered steer, every breast exam and Pap smear, every death-defying drive to the Southcenter Ikea. You get the idea. LEFT: Harts Pass Fire Slope John Voss 26 27 28 Tim Kelly Tim Kelly LET X=Y-2 Mormon Motorcyclist Discusses Chapter One of the Tao Te Ching as I Mobilize His Surgically Wired-Together Wrist Let the mass of the body be halved upon submersion, and the buoyant limbs lay on the surface like long, complicated kisses. Let bodies at rest remain at rest, and bodies in motion, absent frank thwarts and frictions, carry on. Let the sun conduct searches and bones conduct sound. Let the slope of the serotonin reuptake curve be always less than the slope of its rate of release. Let words in their beauty and inconstancy be periodically fire-hosed from the head, and the sensual world, in its radiance, be quietly attended to. Let surprise have a small, candlelit shrine in the corner of the kitchen, and tenderness connect down the valley like the ringing of Italian churches a half hour before Sunday Mass, their massive, shivering bells, incomprehensibly cast, carried centuries ago to their belfries and hung, heavy-tongued, ropes dangling down from their collars, waiting, in slant-light and birdsong, for the hour and the soul who swings them. I name for him, pointing, the hamate, scaphoid, triquitral, three of the eight carpal bones, arranged in the wrist like partially dissolved sugar cubes puzzled into two articulated rows. He closes his eyes to memorize, lips moving over the revelatory words. Name God, he says, watching my hands bending his swollen, stitch-riddled wrist, and you’ve failed to say anything, to discriminate, conjure, or signify the source, the deeper pulse, the essence that infuses this rose-raveled life, the perfection. That’s so, I agree; words are human inventions, and therefore, by definition, imperfect. But useful, surely, practical, even deeply moving, as in a poem or prayer. He says Yes, but the name of the Way is not the Way is what Lao Tsu says. OK, but here I just want to know the actual name of the tiny, stuck, motherfucking bone that’s hurting me. 29 Olivia Quach Interview with Founding Editor, Dr. Daniel M. Becker Danny, where does your inspiration to write come from? Dr. Daniel M. Becker, Director of the Center for Biomedical Ethics and Humanities, the Tussi and John Kluge Professor of Palliative Medicine, Professor of Medicine in the Division of General Medicine, Geriatrics, and Palliative Care at UVA, and founding editor-in-chief of Hospital Drive, sat down with us for an interview about his own journey and formation of identity through writing and medicine. 30 From reading and the need to play around with words and images and ideas. I like the sounds, I like to count the syllables, I liked Dr. Seuss when I was a kid and when I was a parent reading to my kids. I cannot resist wordplay and puns, and even though puns annoy many people, they did not annoy Shakespeare. I’ve felt and nurtured a sense of obligation to the patients and families and colleagues whose stories I enter. But mostly I write about life outside of hospitals and clinics. You don’t have to be dying or in terrible pain to be of interest. Certain images seems to appear again and again in my writing, mostly things I feel affection for—people and places; it’s refreshing and recharging to me to have them enter a poem. Dogs and cats, with and without hats, like to wander through my poems and stories. I never set out to write a poem on a specific topic; instead it usually starts with some curious thing I saw or heard that seems to be ripe with something. For example, a patient was telling me about how their child’s birthday party was based on a spy theme—that got me thinking that’d be a great basis for a poem. It really doesn’t take much to get started. Take me through your thought process when you write. What comes to mind? What words do you go through and how do they evolve? I think poetry should jump around a lot and rely less on logic than sounds, meter, word play, rhyme, and other literary craft devices. Someone taught me early on that poetry discovers its intent as you move down the page, often changing direction as you write. I believe a piece of writing needs to stand the test of time; I’ll finish a piece and put it away for a month before looking at it again. When I return to a piece of writing, I find I may need to scrap it. Revision is very important, and it may often take more than a word change or a line break. Deciding to scrap a poem is like breaking up with a girlfriend— you need to think about it. Often you end up throwing away your favorite line because the poem has migrated away from that. Simply put it into storage to be used in the future. Why do you write? And how did you eventually come to publish your work in so many literary journals (JAMA, Pharos, Yale Journal of Medical Humanities, Ars Medica, Poetry Lore, to name a few)? Writing is a selfish endeavor. It makes me happy. Most people don’t write in order to grieve, repair relationships, or to be better people. They just get pleasure from writing. Though I do think we need to be read—we can’t just write in a vacuum, sooner or later we need to share it. When I was division chief, I used to write poems to the staff for their birthdays and Christmas, and I soon came to realize this was my favorite part of the job. I even wrote patient results into notes as little poems. So I took a writing class at UVA with Charles Wright, and started sending my works to clinical journals that accept poetry. It’s very addictive once you start sending out your work—it’s hard to stop. There is an important difference in the review process of scientific versus literary journals. In scientific journals, you get the opportunity to resubmit, a second and third chance. But in literary journals, you either get accepted or thanked. It hurts to be rejected; it hurts for about five minutes, starts to ache, and then after a day you stop thinking about it. It’s important to emphasize that the primary pleasure in writing comes in creation, not in getting accepted or published. And what’s one thing you wish readers would take away from your work? A smile. So after writing and publishing yourself, how did Hospital Drive get started? What was your vision? About 10 years ago, the dean at the School of Medicine asked me to direct what has now become the Center for Biomedical Ethics and Humanities. The Center is located in a building on Hospital Drive, and it occurred to me that Hospital Drive would be a perfect name for a magazine, as many literary magazines have their origin in hospitals. I went to the dean, told him my brilliant idea, and he said, “That’s a terrible name.” But he liked the idea. I still think it’s a great name. I like the idea that it’s a name that literally is 31 taking you somewhere—you’re entering a creative space, a wonderful legacy of writing at UVA, from Jefferson to Edgar Allen Poe to the great William Faulkner. And whoever tries to write, and tries hard, will want and need readers. Hospital Drive allows novice as well as accomplished writers to meet some readers. If you can’t get the story right, you can’t take care of people. Why do so many literary magazines have their origin in hospitals? What do you feel is the connection between writing and medicine? We sure like to argue that humanities are good for doctoring. You have to respond to patients and try to get the story right. If you can’t get the story right, you can’t take care of people. You have to be curious, otherwise it’s just a gallbladder surrounded by other organs. Once you’re interested in the story, it becomes more than a professional interest—it becomes fascinating, 32 entertaining. Voltaire once defined “art of medicine” as entertaining the patient while nature cures the patient. When writing about a patient, you have to take care that they can’t be identified. To get around this, I’ll often take two difficult patients and marry them and then write about the couple, their dogs and kids, so it’s not that hard to fictionalize the encounters. I steal from patients all the time, also from their families and visitors, even from strangers in the elevator with me. Not everyone knows that you are supposed to be quiet inside the elevator. I think driving to work is a great opportunity to let the mind open all its windows and pay attention to what’s coming in. In speaking about your career, you’ve mentioned that one of the greatest challenges you’ve faced has been struggling with “imposter syndrome.” How do you deal with this? What advice do you have to overcome this? Yes, like a lot of doctors, I suffer from an imposter syndrome. “What is a guy like me doing in a place like this, with all these brilliant accomplished people? Sooner or later they will figure out I don’t belong.” I don’t feel that way with being a doctor. You learn doctoring by getting thrown into the deep end. After that, it’s easy to know what your role is and where you are. But my imposter syndrome is that I’m underqualified to be speaking about writing. I haven’t achieved that much. Even a minor reputation is more than nothing though, so I’ve often been called upon to introduce writing exercises or to represent writers in some way. I think maybe because it’s hard to teach writing. I taught a writing retreat for five summers and found that eager new writers need a really good writer to be pointing the way for them, and I felt like I was only a half step ahead of them. This syndrome is highly prevalent around the School of Medicine where people have a lot of ambition—honorable ambition, but ambition nonetheless. Be honest with yourself and look at your achievements in the proper context; have a few close friends as your professional identity (as a doctor or writer) develops. It’s one thing to be disappointed by a piece of writing, and an entirely different thing to make a mistake in your role as a physician. The best physicians have bad outcomes, but it doesn’t mean you don’t blame yourself. Part of this syndrome is related to the need to be perfect. There are lots of perfectionists who end up in medical school. But we make little allowances for perfection because the stakes are high. Writing is one way to process the privilege of being involved in life or death situations and the way families trust you and let you know their hardest secrets. Sooner or later, we all figure out we can’t always be the smartest person in the room. There are all kinds of smarts. You can make a mistake and patients will still trust you. Trust requires respect. How can we find our identity in the face of this “imposter syndrome”? Why is identity important? What is identity? Do you know what the newest thing in academic medical education is? Professional Identity Formation or PIF. To me, PIF is paying attention to how you change for the good and bad, and being reflective and knowing how it feels to have done a good job and who noticed that and who should have noticed that. Teachers that are inspiring you or what family or patient interaction mattered to you. I remember being a grateful med student who learned from a wise intern that it’s mostly flying by the seat of your pants. Up to that point, my goal had been to learn everything, retain everything, regurgitate everything. The problem with that strategy is the vomit. I remember becoming an independent problem solver myself: being able to see a patient late at night by myself and knowing how to handle that. Knowing when to shut up and listen to an angry family. Knowing how to take a struggling resident aside (and then a colleague) and help them feel better about what they’re doing. There’s more to professionalism than getting charts done on time and wearing a white coat that’s clean. The other piece of identity presents itself when we’re walking alone and the conversation that’s going on. Who’s talking to who? Poetry is full of that. The first person narrator isn’t the poet, it’s the speaker. That’s some other person speaking as “I.” Czeslaw Milosz, the great Polish poet and Nobel laureate, said the “purpose of poetry is to remind us how difficult it is to remain just one person.” Cultivating empathy, trying to imagine what that must be like, what someone would say in a situation like that—that’s what writing is about. A part of identity is to walk about a situation and use different eyes and different ears. Medical school is not nice to your imaginative capacity; it bludgeons that into a corner of your brain. Poetry is supposed to light up all parts of your brain. Which is also what playfulness is supposed to do. Being out of character is good for us, helps us figure out what we know and don’t know or what we wish we did know. I get up early every morning, 33 open Word in my computer, find what I’d been writing the morning before, and get right back to work changing the identity of whoever happens to be speaking. Forget everything you know about psychology and let the characters present themselves. With some of my favorite authors, the characters seem so real and unique, you would think there’s no way they could have been made up. In your years of experience, how do you recommend future writers get started? Read. And if you’re in a demanding field of work, try to read outside of that demanding field. Find some favorite authors, and learn to write by reading their works. If you don’t get a thrill from reading a really nice sentence, then you’re probably not going to be a writer. I encourage writers to keep index cards in their pockets and tune their ears to their surroundings and write down anything they find interesting. Often dreams are worth 34 writing down. They allow us to leap into a different space and be in the presence of something strange, weird, uncanny. Writing our dreams down can help us get back to that feeling in some way. And any advice for young healthcare professionals? A few things. Getting up at 5 AM will not kill you and you actually do get used to it, strange and impossible as that might seem. Long hours? You sort of get used to them, but the days off are well earned. Another, first be happy at home. I gradually discovered—one spring after another—that I can garden and that there’s no place on the planet as nice as the patio next to that garden. Home sweet home. And did you know that petting dogs and cats will raise oxytocin levels for both the petter and the pettee? Cats lower blood pressure, as long as you’re not allergic. One of the great advances in clinical medicine has been the advent of therapy dogs. Our clinic has one: small, calm, quiet, affectionate, hypo-allergenic. Housebroken. She seems to like me best. My secret? I always have dog treats in my pocket. My dogs taught me that trick. They come in handy during home visits. First make friends with the dog. Olivia Quach is a 4th year medical student at the University of Virginia who has always had a strong interest in writing, editing, and publication design. Daniel M. Becker Home Visit We follow a blue Ford tractor pulling a wagon and moving slowly, scattering straw like exhaust, Southside Virginia in July, still haying season, so hot the haze shimmies on the asphalt, June bugs strafe the windshield, the afternoon breeze a warm sponge. The nurse is the guide, telling me how to greet other drivers, lift two fingers from the steering wheel, only two, show some restraint; where to park—don’t crowd the son-in-law who’s not even home, still lord of the roost; watch out for the dog, stretching a yawn, scored ribs settling on a minor chord; who’s who as we edge through the home front porch to back, generations ungapped, no work, no school, no a/c; fans whir, TV promises a better life. We reach the kitchen and in the pantry an old woman with electric hair and petrified eyes hums a gospel, she’s expecting Jesus, sweet Jesus. Surrounded by mason jars and the sterile paraphernalia of age, she welcomes us, more peas in the pod. Light and air succumb to odors fresh and stale, cooking and human. The bed points to a screen door, a mowed field ends at the sky, crows crackle, the sun beckons. Later we admire a huge cabbage, king of the garden, peerless in the weeds. The nurse and the daughter discuss the future, old friends sharing summer plans, arms folded, squinting in the sunshine, staring at the ground. I’m there to listen and agree, there’s some shade and the breeze will last. 35 Dianne Nelson Oberhansly Blossom Houdini Medicine Her father says she is growing speed bumps, a reference to her thirteen-year-old breasts, soft hilltops beneath a yellow tee shirt. The words blossom and Houdini come to mind. After all, a kind of magic is at work. Fleshy lumps and curves, she is being made while an older friend of mine is slowly being unmade, her breast whittled away by something once thought magic and now called medicine. It seems life is wasteful, spilling so much excess, allowing so much beauty that even the cancer when magnified looks like a delicate snow crystal. The thirteen-year-old giggles not yet knowing that what is given can be taken away, suddenly in a white sterile room smelling of betadine and money. Once undergoing surgery, I awoke, looked up into the surprised and slightly fuzzy face of the doctor, asked him if I could see the incision he’d made. Hesitantly he agreed. I raised my head, peered across the bare white field of my chest, saw the newborn hole—a single wet red rose, the scalpel’s offering. Then, with the doctor’s nod, his assistant RIGHT: flooded me with twilight. Water for All Eleanor Leonne Bennett 36 37 38 Dave Morrison Anjali Jain Doctor Lee Quality of Life I have to go to my doctor for back pain— it seems that I have asked me how I felt. I told him that it felt like there were glass rods in my shoulders he said. Finally. A doctor who understands me. It will empty my bank account, and I don’t glass rods in my shoulders held in place with rusted iron pins, and it’s to the held in place with rusted iron pins. “That must be it then,” he said, “What do you suppose we should care. Soon I’ll be able to dance. point where I can’t even shrug. My friend told me about Doctor Lee while I do about it?” I told him that the glass rods needed to be shattered with a billy club wrapped in was signing her cast. “Unorthodox, but none of the mumbo-jumbo.” On my first visit Doctor Lee soft cloth, and the pins needed to be melted with a blowtorch. “That’s exactly what we’ll do.” Dr. Becker it was who said it was important to be able to enjoy a baseball game that that was life still with enough life worth holding onto, clutching, saving. Never mind the tubes for breathing excreting etc., etc. Never mind not being able to get up or down or talk or read or walk or make sense of things whether or not they make sense at all— at all. Just the arc the white line you draw with your eyes white against night chalk against a chalkboard and the roar that thunders that you can feel with the soles of your feet rumbling trembles up your legs to your chest almost you feel like you are there, really there. 39 Rebecca Previs The World’s Shortest Medical Student Stories: Life. Death. Survival. Healing. Introduction Steve Moss, editor of The World’s Shortest Stories, writes: “How short can a story be and still be considered a story?” He describes Charles Schultz’s “Peanuts,” when Lucy reluctantly answers Linus’s request to tell him a story: “A man was born. He lived and died. The end.” The fifty-five-word story offers physicians a quick and dirty way to recount a patient encounter, a difficult situation in the operating room, a passing view of a long parade. These stories can be written while waiting for someone to return a page, while the anesthesiologist brings the patient back to the OR, or while a nurse puts a patient in a clinic room. When I first learned of this creative outlet in my Medicine and Literature class, I became hooked. I rarely have the luxury of follow-up, so these stories don’t have neat endings. Dr. A Surgery HATE CRIME The twenty-something with creamy, black skin, long curly eyelashes. I take the history of all new patients. “It was a hate crime,” he said. “They held me down, heated a knife and carved G-A-Y into my back. I want to join the Army.” The attending examines: “We risk making this worse. Look at the keloids.” DELIVERY Armed guards change shift every twelve hours. My patient, the multiparous inmate, dilates quickly. This Friday night, I will deliver my first baby. I gown, she pushes, my hands wait, empty and ready. Two pushes later, I shout, “Happy Birthday!” I clean the mother, hand over the hungry child, thinking: “Welcome to this cruel world.” Murray Whitehill 40 41 CAULIFLOWER AND CHIPS Surgeons fillet open her abdomen. We peek inside. Friable, cauliflower-shaped metastases cake the omentum, disguise the liver and diaphragm. Suturing her abdomen closed, I know they will offer her salvage chemotherapy. We round. Grandson sits on her bed, feeding her smuggled-in chips. She asks, “Is it gone? Can we go home?” BRAIN DEATH EXAM The book open on the patient’s bed to the chapter on brain death. I stared, heard my heart beat in time with the cardiac monitor. Pinched his finger. Nothing. Harder, still nothing. Pried his eyelid open, cold pupil staring. No corneal reflex. Lifted heavy legs to elicit deep tendon reflexes. Not a flicker. Negative Babinski. ON NOT MAKING A DIFFERENCE An almost fatal accident. Not expected to make it through the night, we do all we can. Trauma, elderly female, no one even knows her name or a family member to call. The intern stuffs a chest tube to relieve her hemothorax. I delicately suture multiple hand lacerations, which matters to no one but me. A NEW UMBILICUS A scrub nurse hands me the needle driver. I feign confidence. Fourteen inches need subcutaneous suturing. I encounter where her umbilicus once was. “Make a new one,” I’m told. I throw in a few extras to make the skin fold. Next morning, her bandage removed, “You’re practically bikini ready,” I say. A survivor of cancer, she laughs. A CURE? Prickly gray hair tufts returned to her bald head, her body ravaged from the chemotherapy. “Bad protoplasm,” the residents said when her abdominal wound opened. Dressing it twice daily, the crater took me ten minutes to fill with fluff. She begged us not to mention the wound vac. She cried. Her ovarian cancer was cured. FAMILY Two brothers lived together all their lives. One went to war, the other stayed home and took care of the farm. They married twins in a double wedding, each had a son only a month apart. In their final days, beds pushed together, they hold hands finding comfort in the silence of time well spent. CHERUB ON EARTH Cherub face crying. His parents never come. Impossible story to piece together: the regression of his development, the origin of his posturing. No one to hold or love him, except the idle medical student. I would never become a pediatrician, but I could carry around this child, rocking him while I wrote my other notes. 42 THREE I enter the room, he smiles. I give him a hug. His caretaker worries about his worsening memory. Could he have Alzheimer’s? I tell him, “Name all the animals you can in one minute.” He begins, “Dog, cat…” He smiles. I ask him again. “Coon?” We smile at each other as the seconds tick by. ANATOMY LAB I despised her body despite her selfless gift to the eager medical student. Her thick flesh dulled the knife blades. Her abundant adipose tissue stained my lab jacket through to my skin. Her body harbored the fumes of preservation burning my nostrils, making my eyes water. Exploring her depths, I knew I’d become a surgeon. THE CORNER ROOM Status post neck dissection, I wiped mucous from his trach each day. Nurses sat at computers, playing games. He longed for a walk in his cranberry-colored pajamas, just around the floor. No one to help him, I lugged the oxygen tank. Announced he would get out of bed, whether they helped or not. IGNORANCE AND CONFIDENCE First day on wards, I stood scrubbed in the OR afraid of contamination. The surgeon barked, “Get a stool, stand across.” He sawed open the sternum, handed me the harpoon-like instrument. “Can you do it? Cannulate the aorta.” I stared him down. “Of course I can.” He admired my confidence, which disguised my ignorance. HOLDING A HEART I held a human heart for three hours. My arm ached, but I dared not complain. I felt high, adrenaline rushing through my veins. What a privilege. After the bypass, flickers of life returned to muscles, the heart throbbed, life returned. I skipped home late that night, did not require sleep or food for three days. 43 Kristin Laurel How to be an ER Nurse First, forget everything you have learned, and trust your gut. You will follow reasonable orders, pass out pills, push drugs into veins, push bodies in carts, in wheelchairs, to x-rays. You will draw blood, dump urine, hold buckets while people puke, hand out washcloths, ice packs, crutches, papers, armbands, attach tubing to noses, into penises, vaginas and veins, up noses, into rectums. You will dress wounds, hold pressure, clean up crap, learn to breathe through your mouth so you don’t have to smell, wipe blood off the floor, wash your hands, and run to the next buzzer, listen to the next set of complaints, take another blood pressure, temperature, ask do you have any allergies, do you have any allergies Rotunda Lady Bobbye Cohen 44 What brought you to the hospital? As you try to listen to the lady with a purple scarf in her hair, distended neck veins, three moles on the side of her cheek who tells you I don’t need to tell you all of this, you’re just the nurse, but she does tell you—about her dog who happens to be a Weimaraner, and she really likes Weimaraners, it’s her third one she’s owned, and they are like children. Last night she tripped 45 over her dog’s leash and aha she hurt her ankle, asks Do you think I broke it, as she stands first in line in the crowded waiting room, with people coughing, sneezing, fingers bleeding to get into this place and that little voice that’s been saving your ass for the last twenty years says, get the lady with the back pain at the end of the line, so you excuse yourself, tag the back pain lady, tell the ER doc, order an EKG, go back out to the mass of waiting people, to the now angry Weimaraner lady with the purple scarf, relieved you brought the back pain lady back because she’s having a heart attack. As you can see, idealism won’t last long. Cynicism will keep calling, leaving messages. You’re not going to save the world, but you are getting paid. Sometimes people tip with a smile or “thank you,” sometimes they throw things and say “fuck you.” You may actually save someone’s life, or at least stop someone else from making them worse, or killing them, including yourself: Pay Attention! You will hold hands as people die, and help keep people alive who want to die. You will become comfortable or uncomfortable with your own mortality; learn there are much worse ways of living than dying. Before you go to work and after you get off work— hug your kids, tell everyone you love, you love them. Never pass up an opportunity to hold a baby in your arms. Look into everyone’s eyes, especially the elderly (of course, only if it’s culturally acceptable). 46 Everybody’s got a story, when you’re not running your butt off, stop and listen. Keep laughing, even if it’s dark. It’s like an old man who was dying of cancer said, Well, I started out in this world wearing diapers, I guess I’m going to leave in them too. Don’t forget to take care of yourself, it’s ok. And if you’re co-dependent, it might be helpful. Who else would do this job? Befriend your co-workers, they are your family for this shift, or a lifetime. Medical people make great friends, with the exception of a few narcissists. Stay away from them. Don’t define yourself by what you do for a living, but what you do as a person. Never forget, it’s the little things, like a warm blanket that can make all the difference. Don’t be afraid to touch, to hug. You are going to see the best and the worse of the human race, and if you get sick of sick people coughing, vomiting, dying, crying, screaming, laughing, baring their souls to you; if your feet and back ache, and your head spins because you’re tired of people getting drunk, stabbing, shooting, and raping each other, smoking, and drinking and eating their way to death, and you’ve read When Bad Things Happen to Good People and you’re still sick of the human race and want to go live on an island, or be a writer…cut down your hours. And if you ever get to the point where you feel you’ve just about seen everything, you just about know everything, or you really don’t care anymore, Hurry up and get out of the ER and close this manual! 47 Kristin Laurel A Drunk in the ER Handcuffed at two o’clock in the afternoon her blond hair is highlighted with red streaks her diamond earrings are caked like her face in a mask of brownish red blood. And that’s all it took— that, and taking off the handcuffs, telling her she’s only here so we can stitch her up. She opened up like an artery… Her breath smells of a dead rotten rodent, curled up and trapped inside her throat. She looks right at me: “Don’t judge me, bitch, you don’t know a fucking thing about alcohol.” I love rehab, I’ve been three times, I’ve got three kids at home, they’re going to be so disappointed with me. I was doing so good, I was sober for a year, then The officer says: “She was pulled over for erratic driving. She blew .30, and when we put her in the squad car she began banging her head against the cage until she cracked her head open.” my dad died a month ago. I went over to the house today to mow the lawn, and found my dad’s bourbon. You don’t know alcohol like I do, The glazed red lines in her eyes have a story to tell a gentler path of tears roll down her cheeks as she sobs: “You don’t know a thing about alcohol.” “I know a little,” I say. how strong it is, how it consumes you, drowns the person right out of you— You don’t know a thing about alcohol— My father’s last words were: “Make me a stiff one.” 48 RIGHT: Sea Turtle & Scuba Diver Teresa Guise 49 Kathleen Cain Graham Fulton Gravity Equinox for Dan From three floors up, outside the ICU window, my brother watches two swallows arc and soar as they chase after some pale thing: Across the room our father gasps for air. The white crane’s neck of the ventilator infuses his chest with air ten times a minute—he must do the rest—although he can barely catch a wing beat of breath. too large for a moth. Flotsam from a shopping bag, as it turns out, rising on August wind, always out of the south. One bird lets go His hands flutter in baby-bird struggle. He lifts his head, intent on rising, then sinks back. Earthbound, in spite of the room, the world: so full of air. of the plastic, no bigger than a feather, to tease the second, which swoops, tuxedo-tail atwist, to snatch the scrap and climb; swift elegance of tawny rose and indigo. 50 You’ll soon be moved to another hospital closer to home when the infection has left and then you’ll be sent home and we’ll have to get you a wheelchair and we’ll have to learn how to use the wheelchair and we’ll learn how to feed you and lift you in and out of the bath and we’ll learn how to wipe your arse and learn how to be mothers and learn how to make you see that you are not a burden which is what you fear most of all but have never been and will never be and all around us is the day of equal night and a door for our spirits that can open or close and the moment to choose the night won’t win. Underwater Stroll Lance Buckley 51 Formation of Identity contest finalist—Poetry Michael Harty At the Assisted Living Facility They straggle across two rows of handicapped spaces, tugging their young toward the wide pneumatic doors, adjusting their faces. Smile, Trevor, Grandpa wants to see you smile. They steel themselves to invade the land of the frail, of Jell-o dinners and the same words over and over in babytalk; of rice-paper skin, veins showing through like parsley stems; of too-warm disinfected air no one breathes too deeply for fear of smelling something dead. They pause at the door for a motorized chair to exit; they go in holding their breath. The man in the chair does not look left or right, nor does he tell them the chair’s name is Trigger. 52 LEFT: Sherborne Abbey Organ Lance Buckley 53 John Krumberger First Session “the therapist is always a mother” —Sigmund Freud At the doorway introduction, his eyes, his hands, his body say “you won’t know me,” then: my sponsor says I should talk to you, meaning: it’s not my idea, meaning: you won’t know me, meaning: I’ve come now you do the rest. And yet here in this place where I preside balding and maternal, silence secures the space between us until my reassuring voice arrives commanding him to his chair where memory is smoothed to a stone suddenly found in his pocket —his story seeping out from an underground spring, the poetry of it surprising him: After 30 years of drinking he wondered where he had been, waking in a hotel in South Dakota to pour his last booze down a rat hole sink. Two wives, two daughters who wouldn’t talk to him; in the mirror the lines of a dry stream bed carved on his face, and outside hay baled and left like boulders in the grass. He watched snow geese in tight formation, recalling the military jets —F14s, F22s—he once flew… Then his voice cracks as he discards his mask and I see he wants forgiveness. I see he is a boy. I see sunlight breaking through a morning fog as I adjust my own mask, moving closer with my chair. RIGHT: God Lives on Brown’s Mountain Harrison O’Connor 54 55 Queen’s Barge Lance Buckley 56 57 Renée Rossi Consent for a Laryngectomy Loss of voice, loss of breathing through mouth, loss of sense of smell and then the uncomfortable pause— a tightening of my own glottis in response to— a textbook opens its glossies in front of my eyes, false cord strumming, epiglottis flapping. What does it look like now? Your glottis is shaped like a star sucked into the night of… what I want to do is anything but operate, let nature take its course as the rambling say in the Texas Panhandle where the great Palo Duro Canyon’s cut out slowly, little by little by a little river, Prairie Dog Town Fork, the byproducts of combustion on human mucosa, bright red 58 Triassic shales, clay, and sandstone litter its rim with dysplasia, then carcinoma in situ, the Trujillo and Tecovas yellow-pink and lavender shales, full-blown invasive finally the Ogalalla sandstone, silt, and caliche, the whole of geologic history in these bare canyon walls a substrata of damaged mucosa, too, and what has this to do with loss of a larynx? You’ll swallow just the same as before, in fact, never again aspirating on a cracker in your windpipe. In the usual sense, no, you will not be able to swim. Water is sucked straight into the lungs. Summer, this landscape is desertlike. Don’t smell and taste go together? Bargaining against the pleasure of years watching sunsets smoking Pall Malls filterless. As protection against dust, the trachea undergoes metaplasia to withstand the now harsh environment, exposure for which you’ll wear a little apron over a bare hole in your neck. Not only water but wind 59 Steve Cushman Work & Family whipping through the canyons over years causes such erosion, too. You’ll drive for miles across the High Plains south of Amarillo, flat, the treeless country inspiring only drowsiness, mirages & so forth, until you enter Palo Duro, overlook the rim of its eight-hundred-foot abyss, at the bottom of which, a narrow ribbon of lush cottonwood awaits you: the alternative, you ask—a slow suffocation though no one will describe that for you. On my first day of work as an X-ray tech, I asked Miguel about KV and MAS. He shook his head, said let’s not make this any harder than it has to be. When I asked about radiation and photons, he said just push the button with the red X. But when I asked about his family, he called me Papi, pulled out his wallet and family photos, started telling me about his wife Anna, and his daughters, Claire and Isabella, and we talked for hours. Smith Surgery Murray Whitehill 60 61 Martha Kaplan Michael Adams A Surgeon’s Geography Fireflies Her brain is open on the table and she is conscious talking with the surgeon you can hear their voices on the tape as the camera focuses on the tiny stimulator that touches on the surface of the gray matter: here, she weeps there, she is joyous here, she loses speech there, it returns one moment her words are clear, focused at the next, her words confused she is lost, muddled 62 her tongue thick and struggling this is a surgeon’s geography mountains and valleys elusive regions of eloquent cortex complex neurological pathways a cartographer’s challenge think the mapping of movement horizontally think the mapping of curved space reduced to squares, lines think what can be touched what is certain and what is not The hard light of day goes soft and long as the sun goes from Wichita, west below the curve of the earth, and other lights, few and tentative at first, not stars but star-like, appear amongst the trees of the shelter belt. And as the first true stars come out, the lights, the living lights, become bolder, venturing out onto the verge of prairie fronting the highway, and others appear, as if coalescing from the thick air. It’s been many years since I last saw these brave luminous lovers that filled summer evenings, years since I left the soft breathing hills of Pennsylvania for the sun-washed bones and peaks of Colorado. They stake everything on this night, these small creatures, and my heart goes out to them, already sensing the stirring of the bats, swift and deadly amongst the trees. I think our world is no less fragile than theirs, and we are just as foolish as they to venture forth into the red reach of life. But if we choose not this boldness, never to venture forth, but to remain always hidden, have we lived at all? Come with me. I want to show you this night, force your door, kick out the jams, throw open all the windows and lead you out into this June field so that you will see all of this brave dance, this so short, impossible beautiful life. 63 Formation of Identity contest winner—Prose This idea of identity changes for each of us all the time. And there is, perhaps, no greater time of questioning who we are than when we are suddenly sick. Like the character in “He Was Henry Hudson,” the experience of illness throws us into a tailspin, requiring of us a new interpretation of ourselves in this world that seems, without warning, to be so different. In this story, Linda Chase tosses us directly into the churning water—Henry Hudson navigating the mighty river. What I love most about this piece is how this introduction mimics the experience that is then described: the unreal reality of having a stroke, the way the injured brain contorts events into metaphor that makes this tragedy meaningful, metaphor that even becomes therapeutic. As the story progresses, the writer keeps us just the slightest bit off balance and leaves us in that allegorical place, searching for the pinprick of light that we hope will guide us back to a more familiar sense of ourselves. —LK 64 Linda Chase He Was Henry Hudson He was Henry Hudson, navigating the mighty river, heading north. He loved this river. His river. The sheer power of it, the expanse. The night was coal black. A thick darkness cloaked the banks that rose on either side, steep as cliffs. He felt them breathing like living things. He could not see the way forward but he felt his hand steady on the helm. He must stay the course. The land was a force, and the night was a force, but the force of the river was stronger. Wilder, deeper. Fathoms deep that could not be fathomed. The sails snapped taut in the brisk wind. He felt the speed like a pulse, his heart beating at one with the motion. Steady ahead, moving swiftly, the strong river current driving them on, urging them north toward Albany. He could feel its lulling cadence beneath him. True north, true north, true north. But no. A worry flickered like a hazy, indistinct constellation. It was now, it was then. He was lying on his back. He was the captain of the ship. Now was then. Then was now. He was Henry Hudson on a great voyage up the mighty river: he was lying on his back, the ambulance tires thrumming beneath him. Where was the North Star? Something nagged, something about the current. Didn’t the current run south? Thoughts traveled light years through the synapses of his brain, dying stars that were gone before they arrived. Where was true north? How would he know when he had found it? It had seemed a normal day. Tom was in his studio in the barn, putting in long hours as he always did, working on the final painting for his upcoming New York show. I had gone to town in the late afternoon to buy groceries, and he came in while I was unpacking the bags. He must have been listening for the car, I think when I see him, because he is usually oblivious to the outside world when he’s painting. I often tease him that someone could back a truck up to the front door and load up all the furniture and he wouldn’t even notice, but as I glance at him now, he doesn’t look in the mood for teasing. Something strange happened while I was gone, he tells me. A stock broker called, of all things. He could hear the man on the other end of the line but he couldn’t answer. He knew what he wanted to say but his mouth wouldn’t form the words. “If the guy knew how little we have to invest, he wouldn’t have been wasting his time,” he says, forcing a laugh, trying to make light of it. “Anyway, I feel fine now. I felt fine then. I just couldn’t talk. It was weird.” He is speaking perfectly clearly as he says this. We stare at each other for a couple of minutes, not knowing what to think. I have bought a cooked chicken and some coleslaw so we set the table and sit down to eat. We know we should take this episode seriously, whatever it is, but we don’t want to panic. Could he be having a stroke or something? We have a general idea of what a stroke is but have never paid much attention to the symptoms. It is one of those things that didn’t seem to have anything to do with us. This is before we have come to know all the signs of stroke by heart, before we have read or even noticed those posters in every hospital corridor and doctor’s waiting room. The ones that tell you to Call 911 immediately if you experience any of the following symptoms—sudden trouble speaking, we know now, is high on the list. We are young, or at least we still think of ourselves that way, and have hardly given stroke a thought. Besides, Tom is a runner who does four miles almost every day. At sixty-one he has the blood pressure and cholesterol of a man in his forties. And if it was a stroke, how could he be so lucid now? These are the things we tell each other, attempts at reassurance, so maybe we know more about strokes than we think we do. Just not enough. Still, I do call the doctor, getting the machine because it is after office hours. I leave a message, thinking all the while that I am probably being alarmist. So we sit down to eat, a little worried, sure, but not worried enough to consider rushing off to the emergency room. Not as worried as we should be. And then Tom drops his fork. He is raising it to his mouth about to take a bite, and it just slips from his hand. It lands on the plate with a clang that makes us both jump—literally lift off our seats like cartoon characters. Our eyes catch. We know this He was the captain is bad. He picks of the ship. Now the fork up again was then. Then but can’t make was now. his fingers hold on to it. “I don’t think we should wait for Dr. Collins to call back,” I say, but just then the phone rings. “Call an ambulance right away,” she says when I describe what is happening. 65 We are sitting at the round table in the bay window; the phone is above the kitchen counter by the door. I turn back to Tom and see him starting to tilt sideways off the chair. There is the barest hesitation, and then his body starts toppling, rigid as a tree being felled. I drop the phone and rush over to break the fall. He has suddenly become a dead weight, so heavy that I can barely keep him propped up. But I have to make the 911 call. I stretch out my arms and am just able to While ignorance in keep one hand this case is certainly supporting him not bliss, it is at least while I reach for a blessing. the phone with the other. It isn’t a cordless but at least the numbers are on the handset so that’s a help. Once I have it in my hand I can just pull it out far enough from the wall to dial while I lean against Tom to keep him up. It’s a weird balancing act. If I drop the phone I will not be able to get it again without letting him go. We live in a very remote rural area. The hospital is at least nine miles away. 66 Our house is on an obscure winding road, notoriously difficult to find. My friend Dorothy lives halfway between us and the hospital, and the ambulance will have to drive right by her house, so I hang onto the phone and call and tell her what happened and get her to watch for it and flag it down and make sure it gets here. My hands free now, I put both my arms around Tom and lean against him so he won’t collapse to the floor. “It’s okay, the ambulance is coming,” I tell him. The kind of meaningless soothing words you say to a child—to yourself. He can’t speak, and I don’t know if he hears or understands me. He seems lost somehow but there is flicker of fear in his eyes that I want to assuage. At least his eyes don’t look completely blank, I think, telling myself that this is a good sign. It’s another half hour at least before the ambulance arrives. The paramedics quickly wheel a gurney into the kitchen, place Tom on it, and wheel him out. Despite what you see on all those shows on TV, they won’t let me ride with him, so I squeeze his hand and tell him again it will be alright, still not sure what of all this he comprehends. It all seems far too unreal to even begin to imagine what alright might mean. The next hours are a blur of anxiety. The small local hospital is not equipped to deal with stroke patients but has to process him into the system anyway. He needs to be airlifted to Albany, they say, and so we wait for the helicopter that ultimately can’t land due to heavy fog, and then for another ambulance that is licensed to take him the two hours to Albany General. I have no idea, as I get into Dorothy’s car, that time is in any way crucial. While ignorance in this case is certainly not bliss, it is at least a blessing, since I am helpless to make any of this move faster. We can’t follow the ambulance because, after all this waiting, it takes off too fast. We naturally assume they will get to the hospital ahead of us, but when we arrive the admissions nurse tells us she has no record of Tom or of any patient arriving by ambulance. “But you are expecting him, right?” I say. “The hospital in Margaretville said they called ahead so the doctors would be ready.” She has no record of such a patient or any such call, she insists. We should have a seat and wait. We sit down but I get up almost instantly. The ambulance definitely should have gotten here by now, and I don’t understand why there is no record of the other hospital’s call. Dorothy follows me outside to watch for its arrival. More waiting and pacing, and I am truly getting frantic. I go back inside and ask the nurse behind her protective glass to check again, and she repeats her assertion that there is no such patient listed, her annoyance palpable. There is a pair of double swinging doors next to this admitting office, and I can glimpse the treatment area through their small square glass panes. Whether it’s intuition or just frustration that impels me, I push the doors open and, against the nurse’s protest, rush inside. It seems to be just one large room with several rows of gurneys, most of them unoccupied, and then I see Tom on a stretcher being pushed through another set of doors around the corner by a burly man in green scrubs. “I’ve been going crazy waiting. Why didn’t anyone tell me he was here?” I say to one of the nurses standing nearby. “Are you the wife, then?” she asks, without any hint of apology. “Well it’s a good thing you got here. He’s been to radiology and they’ll be wanting to move him up to a room upstairs soon, and I need you to fill out some paperwork.” So he has been here awhile, although no one thought to let the emergency room admitting office know. I want to scream in anger and frustration, but I don’t want to upset Tom. I’m not much good at screaming anyway, so I go over and stand next to him and stroke his arm. He looks calm. His eyes rest on me with seeming recognition but without any apparent sense of relief, so I guess he has not been frightened or worried about where I was. At least that is something, but it is also scary. If he doesn’t know the trouble he is in, what does that say about his brain function? Is he in some kind of coma, or just zoned out? There is definitely a disconnect. Maybe it is just some self-protective mechanism the brain has. Some kind of automatic shut-down, like a computer that freezes when it gets too much conflicting input. I suddenly get a vision of the “Fatal Error” message that would flash on the screen of my old IBM when I hit some mysterious combination of keys that forced it to crash—a drastic and startling message even in reference to a machine. I don’t have time to dwell on this, however, because the man who was pushing Tom’s stretcher comes striding up. “You are wife?” he demands. His face, aggressively close to mine, is ruddy, and his hair, the color and texture of wet straw, juts wildly around his ears. “Massive stroke,” he says when I nod. “We look at picture. CAT scan.” At least I think that is what he says. His accent, clearly Russian, is so thick I can barely make out the words. I think he is saying something about the parts of the brain, but I can’t be sure. “What?” I say. “I don’t understand.” 67 He presses even closer, his whole body hovering belligerently. “Massive stroke,” he says again, waving his arm dismissively over Tom’s inert form. “Massive.” That part is very clear. I look around and see the nurse I had spoken to before standing off to the side. “Can you explain what he’s saying? I can’t understand him. His accent’s too heavy.” I am trying to speak quietly, but he has apparently been listening for the complaint and has homed in on my voice like a radio scanner tracking a frequency. He is immediately beside us, on top of us, waving his arms. “What do you mean? Why do you say that? You want I “He raised his finger,” should be fired? I call out to the I speak well. You doctor. “I saw it.” are problem.” With his red scrunched-up face, heavy accent, and childish grammar he is like a Robin Williams caricature of a Russian doctor. If this were a movie I would be laughing. I don’t want to risk Tom’s care by alienating this doctor—if that’s what he is—any further, so I mutter an 68 apology and go back to stand next to Tom. Fortunately, Tom seems not to have noticed any of this. “Paralyzed. Not move. Very bad,” the Russian pronounces from across the room, and with another dramatic wave of his arms he pushes through the double doors. In the calm that follows I lean down and speak quietly in Tom’s ear. “You know you have had a stroke,” I say. I’m not sure if telling him is the right thing to do. I only know that if it were me I would want to know. If there is any part of his brain that is aware enough to be confused about what happened to him, then he is be better off knowing at least that much. Now I am sitting by Tom’s bed where he lies asleep. He is hooked up to an IV pole, and the metal bed railings are up so he won’t roll over and fall out. There is no possibility of lying next to him and holding him or even sitting next to him on the bed, so I reach through the bars and hold his hand. It is impossible to know what will happen next. The first twenty-four to fortyeight hours are the most critical, the admitting intern has advised me. There could be another stroke, or the damage to the brain could continue. There is nothing to do but watch and wait. If we had gotten to a hospital with the right facilities soon enough, they might have been able to give him blood thinners, which could have reduced the severity of the damage, but the window of opportunity for that kind of treatment is only three hours. Any intervention now would be too risky. If he has another stroke there is nothing they can do to stop it. I have sent Dorothy home. She will come back tomorrow and bring whatever I need. I have no intention of leaving Tom alone. There is a hard, plastic-covered reclining chair next to the bed. One of the night nurses has brought me a pillow and a blanket, and I lean it back as far as it goes and try to sleep. Exhaustion fights with fear. I doze and wake, doze and wake, twisting on the harsh scratchy surface. Every few minutes I sit up and look over at Tom, searching for the rise and fall of his breathing. What if this is it? What if he doesn’t recover at all? I am terrified for him but so grateful he is alive, and I hope I am not being selfish. He is still here; that is the consolation I am holding onto through this terrible night, and I have to believe it will be a consolation to him too. Yet I know if Tom could speak to me now, he would say unequivocally that he would rather be dead than alive and totally paralyzed for the rest of his life, that for him a life of helplessness, a life in which he couldn’t paint, would be no life at all. It is way too soon for such thoughts, I tell myself. Too soon for fear, too soon for hope. Too soon for denial, too soon for acceptance. I hold in my mind the Tom I know, the Tom who has always had so much energy—energy for work and love, and nervous energy too. So much nervous energy that he could barely sit still, tapping his foot unnervingly on the gas pedal when he drove, and incessantly drumming his fingers on whatever hard surface was around, rhythmically tapping out streams of words in the Morse Code he had learned during his stint in the Navy, his speed at the keys making him a crack radio operator. I look at him now and, physically at least, it is like looking at a different person. It isn’t just that his arms lie limply on the stiff sheets, drained not only of energy but seemingly of life itself. They seem to have actually shrunk, withered. He looks like someone who has been lying immobile in a hospital bed for weeks or months not merely hours. How can such a transformation happen so quickly? Can it really be that it is only the electrical impulses from the brain that keep the muscles taut? Or is it some kind of reaction of the body to the trauma of the stroke? In its own way this diminishing is as shocking as his inability to move or speak. It is after ten the next morning when Dr. Abramowitz, the neurologist, arrives. A tall man with a small goatee and thinning dark hair combed back from his forehead, he looks like a nineteenth-century European intellectual, but he exudes a twentieth-century fit, compact energy. Blessedly, he speaks perfect English and seems reassuringly sane, even kindly. He asks Tom to lift each hand and each leg in turn, although it is immediately clear that Tom cannot comply. Then he approaches the bed and gently lifts each hand and lets it drop back down. After this, he takes a pin and pricks Tom’s finger. “Do you feel that?” Tom shakes his head, a small movement but enough to indicate a no. He doesn’t feel any of the pin pricks, but he can move his head, and there is no doubt he understands what the doctor is asking. “Do you know where you are?” the doctor asks next. Tom nods this time and looks like he would like to answer but doesn’t try to speak. “Do you know what year it is?” The same nod. There is no point going on with this series of questions, a series we will soon come to learn so well, designed to test the patient’s orientation to time and place. He picks up Tom’s chart from its place at the end of the bed and reads it. Blood pressure: 110 over 70. Resting heart rate: 60. “You’re in better shape than I am,” he says with a straight face but clearly aware of the irony. 69 Tom has had an ischemic stroke, he explains, as opposed to a hemorrhagic stroke that would involve a bleed in the brain. The right carotid artery appears to be completely blocked, cutting off blood flow to the right side of his brain. As we just saw, he is almost completely paralyzed and has no feeling in his hands or feet. Since the stroke was on the right side of his brain, it will primarily affect the left side of his body. If he lives, there is a good chance he will regain some, or possibly all, use of his right side. It is too soon to know if the speech areas of the brain have been permanently affected or if he will regain any functionality on his left side. The good news: he is still young and obviously in good shape, and that should help his recovery. “I don’t want to mislead you. The CAT scan showed extensive damage to the brain. When the blood supply to the brain is cut off, the brain dies. Cells that have died are gone; they do not regenerate. Sometimes the brain can learn to compensate for some of this loss. It’s too soon to know 70 the true extent of the damage much less how much recovery is possible.” He isn’t ruling anything out, the doctor says, but he doesn’t want me to expect too much. Those words “massive stroke” keep replaying in my head. “If he’s in such good shape, why did this happen?” I can’t help asking, but the doctor has no answer to that. Tom has been watching us through all this but it is unclear how much he has heard or understood. His arms are still lying lifeless outside the covers, and I am thinking about what the doctor has just said about his condition, and then I suddenly see the index finger of his right hand lift off the sheet. “He raised his finger,” I call out to the doctor. “I saw it.” Dr. Abramowitz comes back in and stands behind the bed. “Do it again, Tom,” I say. “Do what you just did. Move your finger.” It takes a few seconds. You can see the concentration in his face as the thought gets routed from his brain to his finger, but then there it is, the slight but unmistakable movement. Then he does it again, lifting it a little higher the second time. “This is really excellent,” the doctor says. “Any improvement in the first forty-eight hours is a good sign. And this isn’t even twenty-four. We still don’t know what the outcome will be, but as a general rule the stroke patients who show improvement in the early stages have the best recovery outcomes. I don’t want to mislead you, but this is a good sign. Really encouraging.” It’s strange how some moments impress themselves so vividly on your consciousness while others just as crucial seem to slip by. I can picture the exact motion of Tom’s finger as he lifted it a half inch off the starched white sheet of that hospital bed, but I can’t recall the exact moment when he started to speak again, even though that would seem an even more momentous occurrence. Perhaps this is because the ability to move at all was the first sign of hope; the fact that he repeated it for Dr. Abramowitz proved beyond question that he both heard and understood us. Maybe the leap from understanding to speaking didn’t seem so amazing. Or maybe I was suffering some combination of shock and exhaustion that prevented me from registering his first attempts at speech. Maybe I had asked him, as I did so many times, if he was in pain. Or maybe I asked if he understood what had happened, if he knew he’d had a stroke, and maybe instead of nodding he mouthed the word yes. Maybe I wipe his first words out of my mind even as Tom speaks them because they are so painful to watch. As he starts to gain movement on his right side throughout the day, his left side remains completely paralyzed. The left side of his face droops, flaccid and immobile. His first attempts at speech are garbled and barely comprehensible, and worse than the sight of his drooping face is the distress in his eyes as he struggles to get the words out. More than the paralysis, his difficulty speaking brings home to him the truth of his condition; it is the first evidence that his brain cannot ignore. By the time Dr. Abramowitz makes his morning rounds the sec- ond day, Tom is managing to speak well enough to try to answer the classic roster of questions. “Do you know what year it is?” It’s something of a tongue twister but he gets it out: “Nineteen ninety-nine.” The doctor is obviously pleased. You can see it in his eyes, though he keeps a straight face. “Do you know where you are?” Tom nods. “Wish I didn’t,” he mouths, managing a hint of a lopsided smile. “Okay, but where is it?” I’m surprised and delighted by this flash of humor but the doctor wants to be sure Tom knows the right answer. It is unclear if he even thinks of the humor as a good sign. We will soon learn that no matter how many times these same questions are asked, the doctors want them to be answered correctly so the answers can be checked off on the chart. “Albany Hospital,” Tom manages, chastened. “Good,” the doctor pronounces, though I can’t tell if he is as impressed as I am that Tom does really know exactly where he is. It is another day before they get Tom into a wheelchair and allow me to wheel him out into the hall. There is a small seating area next to a large window. We are on the twelfth floor, higher than most of the buildings in the medical complex, so the view is We are on the mostly blue sky. twelfth floor, higher In his two-bed than most of the room, Tom was buildings in the in the bed nearmedical complex, so est the door, and the view is mostly with the other blue sky. patient’s curtain pulled closed it was impossible to even see the window. We could barely tell if it was day or night, not that it seemed to matter. But now the glimpse of the outside seems to perk Tom up. “Henry Hudson,” he says. His speech is still difficult to decipher, slow and slurred as if his tongue is too thick, so he has to say it a couple of times before I understand the meaning. “I was Henry Hudson.” “You mean you were dreaming?” He shakes his head. “I was him.” I don’t know if it is seeing the sky, or sitting up for the first time, or just the 71 fact that enough time has elapsed for his brain to begin to grasp where he is and what he has been through, but suddenly he wants to explain it. Despite his struggles with forming the words and frustration that he can’t get it all out fast enough, he is in a hurry to share it with me. “We were sailing up the Hudson,” he states, as emphatically as his speech deficits allow. Then he must pick up on my distress and confusion, my fear that his brain is not working right after all, because he looks me in the eyes and adds, “I know I was in the ambulance, but I was him, sailing north.” He is so pleased with himself—so pleased that he has been able describe his experience, and so pleased with the memory. “It was amazing.” He will tell this story over and over again in the days that follow. Clarifying it, reiterating the sense of reality it had, wanting me to know how detailed and elaborate his concept was. He wasn’t just sailing up the Hudson, he was the captain of the ship, concerned about his men. They were counting on him. He knew he needed to navigate 72 by the stars, but it was too dark. Dr. Abramowitz has tried to prepare us both for the future. He has told Tom he may never walk again, and that it is unlikely he will ever be able to paint again. But fortunately Tom hasn’t been listening to any of that yet. He is still on the ship navigating the mighty river. I have no idea what to make of this fantasy, and I don’t know if it is good to encourage it, but he clearly enjoys remembering it and talking about it, and it’s wonderful that he is talking at all. I try to be logical about it, to think where the idea would have come from. The New York Thruway does run north along the Hudson, and we know that was the route the ambulance took, but how could Tom possibly have known that given the condition he was in? He was flat on his back hooked up to monitors, so he couldn’t see out the window. And even if he could have, even sitting up in a car, there is no place you can actually see the river from the thruway. He is something of a history buff, but as far as I know he hadn’t been reading any books about Henry Hudson or the river or the history of New York State. I can’t remember a movie or PBS special that might have triggered it. We do drive over the river occasionally, taking the Rhinecliff Bridge to dinner in Rhinebeck or driving to visit my brother in Connecticut, commenting on how beautiful and majestic it is, but we haven’t even done that in months. It is easy to assume that the ship Tom was captain of was his own body, that his inability to navigate and his fear of leading the ship aground are perfect metaphors for his condition. But that seems too pat. There is something deeper in the poetry of his vision. I was so afraid that he was afraid as I rode in the car, making my own trip north that night. I was afraid he was feeling lost and alone and abandoned and maybe in pain. But he was in a better world. He was Henry Hudson, sailing up the mighty river, scanning the heavens, searching the celestial hemisphere of his brain for the bright pinprick of light that would be his North Star. Mother at 92 Harrison O’Connor 73 John Casey My gift was guessing I. My gift was guessing. I saw the invisible letters In the faded word where the ink thinned on the nib Or where a right-hand margin had rotted from Centuries of monks’ thumbings. I wore white gloves. We know the Gospels. No need to guess. I read Chronicles scratched in Latin that was neither A mother-tongue to the chronicler nor me. Word by word I’d learn his style of writing— His stylus I should say. How literal my view: Ascenders, descenders, the cold squeeze or globed Ripeness of his half-uncials. Then a blank. I waited in the dark. I cannot say That I was patient. Patience, like bravery, is a virtue For one who doubts the outcome and persists. I only waited, daydreaming á la Proust. With the same alertness that he surely felt When he heard the clink of a spoon against a saucer And knew that he was about to begin to remember. The Northmen’s boats…the Northmen’s boats…did what 74 Upon the shore? An s, an illegible inch, Nothing more…Sibillaverunt. They hissed. I’m sure. Spectography confirms Only the tops of the b, the l and the t. What else could it be? The ships came sailing silently Out of a white fog, then hissed on shore. My monk is fanciful but true to sound. And sight. The long boats’ upcurved stems are dragons’ heads. That was an easy one. I’ve mused on pages that had As many lacunae as words and arced the gaps. I remember how my senses hovered Over the vellum, not just seeing but hearing Murmurs—my brother monk mouthing the words, Lifting and pressing his pen and lip simulatur. II. It wasn’t a stroke. That was still to come. It wasn’t a stroke—it was just that one day I couldn’t do it. What I’d done with ease Didn’t become more difficult; it stopped. I kept on knowing dead things I already knew But not the joy of words coming back to life. The slow diminishing that followed disturbed me less. Perhaps my fear of death is also less, Perhaps by paying that loss in middle age My timor-mortis-conturbat-me was deadened. III. Here’s how I know what is going on: a nurse Comes on at night. She speaks a sing-song English, Not her mother’s tongue. Her full-moon face Is Chinese. She hears every word I say— Or try to say. Perhaps she reads my lips, Perhaps she’s good at guessing. She knew I laughed. “You laugh. That good. You still see what funny.” She knows my favorite juice, she brings the cup Although I barely pull my lips apart To make a “pah”. She says, “You like papaya. Good, good. Papaya good for you.” She reads my eyes—“You sleepy.” I close my eyes To let her rest. Why is she reading me? I thought at first that she’s reading me to mark the end, An ornament of figure-ground reversal. That’s what made me laugh. I’ve changed my mind. Why is she reading me? Because it is her gift. The Northmen’s boats flowed into words and faded. Did it matter whether they were found once more? Not the fact of boats but on what word The chronicler floated them on shore. Not papaya, but the grace of being heard. 75 Formation of Identity contest finalist—Poetry Laura Foley Film Noir Kids at Art In Paris with my professor, and his shy teenage son, not much younger than I, whose presence I try to fence from my awareness. Our apartment’s an atelier, our courtyard shaded with Trees of Heaven I look down on before descending the new brass elevator, clanging through the ancient stairwell’s Stygian depths to sip bitter espresso and smoke filter-less cigarettes as if I were born doing it, all that summer, pretending I’m someone else. Murray Whitehill 76 77 Kendra Kopelke Our Urologist Looks like a grenade exploded in your bladder, Dr. Z chants in the chilly examining room after the catheter comes out. Looks like a bomb went off in your bladder— he announces in the recovery room in his green scrubs, across my husband’s groggy body. Looks like a bomb went off in your bladder, he intones to the four walls in his sterile, shared office, well hung with diplomas bearing different names, Art at the High our own private, wartime poet, armed with one metaphor, one hackneyed phrase, and chemicals. Lance Buckley 78 79 Kendra Kopelke Pointing The Finger The bladder is not to blame, the mitamycin is to blame, and before that, BCG, or bovine tuberculosis, and before that, cancer, and before that the doctor who 80 diagnosed you and before that the other doctor who misdiagnosed you and before that, radon, grilling, Baltimore, and before that me, of course, and before that, family history, dumb luck, the country we swim in pumped full of chemicals. My finger is almost as red and tired as his bladder having pointed itself to death. It has poked suspiciously at the poisonous world, taken inventory even in my sleep, testing each thing to see which makes the most sense, looking for the foot that fits this shoe. What or who did this to you? Oh, but I wonder, what is the point? To increase suffering? Invite more guilt? Deepen regret? If only you hadn’t worked in the leather factory? But you never worked in the leather factory! If only you had worked in the leather factory and smoked a few cigarettes along the way, so we could, for that brief surreal stint in the doctor’s tiny cockpit, sigh ohhhh that before taking off to points unknown. 81 Marsha Roberts Tweaking Fate 82 Sunset Mountain Armando Huaringa My mom is sitting across from me at Starbucks, waiting for her life to change. Of course, she doesn’t know that’s why she’s here. On the contrary, she’s completely absorbed in her lemon ginger pound cake—has undone the button at her waist, in fact, to welcome it. We’re both understatedly cool in all-black—my mother, because it’s the de rigueur ensemble for 81-year-old Italian widows. And me, because I’ve lived in San Francisco forever and, as everyone but the odd tourist from Pennsylvania knows, that’s all we wear here. Our personalities are colorful enough. She’s pissed off about her appearance, of course. Before leaving her house, she checked herself out in the hallway mirror and scowled, as usual. Her sparse, gauze-like hair wouldn’t cover all of her pale pink scalp no matter how much she played with it. The collar of her black sweater didn’t cooperate either, refusing to stretch and hide more of her chicken neck. A little makeup would have helped, but I was unsuccessful in that department today. It’s important to celebrate the small victories, though. She agreed to go out. And her life is about to take a turn for the rosier. The coffee shop is pretty quiet; most of the tables are empty. But not the one that counts. I slip a look at it. It’s zero hour. “Mom, I think that guy over there is checking you out!” My timing isn’t ideal. She’s just angling her fork toward the creamy, lemon rind-flecked filling, going in for the kill. Her murky blue eyes look up at me, more clouded than usuSubtlety is one of the al. My real mom used to be in first things to go. It drifts those eyes. I’d like to see her away…well, subtly. more often—at least a wisp every now and then would be nice. “What are you talking about?” Her eyebrows shoot up too far, as though I’m the one who’s nuts. “That man over there, in the tweedy jacket, sitting by himself,” I say, pointing with my nose. “He’s been staring at you ever since we sat down.” She turns to look at him—flat out gawks. Subtlety is one of the first things to go. It drifts away…well, subtly. He’s in his early eighties. His white hair is combed straight back in thin cords that have a faint sheen— 83 Brylcreem, probably. He is peering at his paper through perfectly round, horn-rimmed glasses—when he isn’t sneaking a peek at her, that is. His lips are full and generous, the kind that would bite right into a fresh peach and not mind the juice running down. “Don’t be silly.” She turns back He weaves the details to me. “I am too old for a man to I give him into memories be interested in me.” She strings even I begin to believe. out the “o-o-o-ld.” “Men like him, they are looking for younger women…nobody wants an o-o-o-ld lady like me.” She goes back to her cake. He stands up, folds his paper, and walks toward us. “Mom, he’s coming this way!” She ignores me, or doesn’t hear me, I’m not sure which. Then again, not many men can compete with the sweet, tart feel of lemon frosting in your mouth, so she probably has a point. “Excuse me, ladies.” He is hovering at our table, his voice a cheery lilt. “I’m very sorry to bother you, but you look so much like my old neighbor back in Silver Spring, Maryland, I just had to stop and see if it was really you. Are you Gina Giordani?” His eyes are a gentle, dark brown, and they are fixed on my mother. Her sleepy face jars into recognition. “Yes, yes…I’m Gina Giordani.” She says it as though just realizing it herself, emphasizing the syllables with that melodic accent she has managed to keep sixty years after leaving the old country. 84 “I’m Carl O’Donohue. Remember me, from Linden View Drive?” He has the kindest face. “Carl!” Her lips form a perfect smile, but her eyes are lost. “You used to play canasta with my wife, Shirley.” “Oh, Shirley, yes!” She nods vigorously and leans forward. “How is Shirley?” I invite him to join us, and he pulls over a chair. He squeezes his hulk of a frame between us and brings with it an air of warmth that wasn’t there before. And also a tinge of something else from way back when—Old Spice. “I’m afraid Shirley passed away five years ago. Cancer,” he says. She sinks back in her chair with a soft moan. “Oh, I am so sorry. She was wonderful, Shirley. When Henry brought me to America, I didn’t know anyone. Shirley would invite me over for coffee. She introduced me to the other ladies in the neighborhood. And she taught me how to play canasta. We had a wonderful time. Each of us would take turns bringing some dessert. They always asked me to bring my tiramisu. I used to make tiramisu from scratch, you know, my mother’s recipe. And we would talk and talk. Shirley was my first friend in America. I am so sorry that I lost touch. And how is she doing?” Carl repeats his answer and then looks at me, pulling back until I’m in focus. “Let’s see, you must be Margaret?” “Yes. I go by ‘Maggie’ now.” “I remember we could see you out our kitchen window, swinging on your swing-set.” He turns back to her. “And Henry? How is he?” For a moment, she leaves us and floats into the past where my dad lives. Her creases soften. “Henry died….” Her eyes search mine. “How many years ago?” “Also five years ago. Also cancer.” Carl’s head sinks with the weight of one who knows what it’s like. “Henry was such a good man.” There is an awkward pause, while we each struggle in our own way to find a graceful segue. Carl gazes out the window, watching a scene only he can see. Slowly, a grin begins to form. “I remember when Henry and I were ushers together at Our Lady of Mercy. This one time, a teen-aged girl came in late, wearing a very short mini-dress—strapless, no less. Henry was beside himself. He took it as an insult to the church and everything it stood for. He went right up to her pew, whispered to her that she was inappropriately attired for the service and escorted her out on the spot. I don’t know whose face was more scarlet—hers or his!” Carl was chuckling out loud now. And so was Mom. “Yes, yes, he was very strict, very proper, but a very good man. I miss him.” She studied her lap. I excuse myself to let them talk. A half-hour later, when I return, they are hunched over the table, deep in stories of the past. My mom is pointing her finger at him, her lips wide with glee. “You are right!” “Right about what?” I ask. “Oh, you know, everything. He is right about everything!” I don’t press—I know she can go no further. Instead, I play my part. “Unfortunately, Mom, we have to get going now.” Carl steps right in. “Gina, I’d love to get together some time, if you’d like. It’s so nice to be able to talk with an old friend. The truth is, I don’t know many people here.” His lively eyes dance under the thick white forest of his brows. “I found this great Northern Italian restaurant near here. They make the best tiramisu. Well, not as good as yours. Would you like to go there with me sometime?” “Oh!” She starts playing with her necklace, the one with the mango and banana colored beads with shiny crystals in between. It’s not the worst necklace she owns. It’s the third worst. It’s twirling in her hand now—a hand with too many bones and veins. I nod and wink in encouragement. It doesn’t work. Now she is stammering “I, uh… I, uh …” This is moving too fast. I should have known better. “Tell you what…” I jump in. “My mom and I come here for coffee all the time. How about if we meet you here on Thursday, at two o’clock?” And that’s how it starts, at least as far as she is concerned. We meet every Tuesday and Thursday afternoon at Starbucks for three weeks. Carl is Oscar worthy. He weaves the details I give him into memories even I begin to believe. And he does it with heart. And she…well, at first of course, she doesn’t even remember meeting him. Not ten minutes after getting home that first Tuesday, she asks me why we never go to Starbucks anymore. And that sets her off into her standard complaint 85 that I never take her anywhere. I remind her that we go out together at least three times a week. “No, we don’t! Maybe once a month—maybe…if you have time.” It’s useless to argue, I’ve finally mastered that lesson. So I try to change the subject. But she won’t let it go. She ups the ante, moving on to one of her favorite taunts. “You are so selfish, you know.” She draws It’s the illness, out the “sellllll-fish,” winding I try to convince myself. her tongue around it like a It’s not really her. noose. “You didn’t have children because you are selfish, and now you don’t want to spend time with me because you are selfish.” No matter how many times I hear it, it never loses its sting. The unfairness just boils there at the top of my throat, wanting to bust out and set her straight. It’s the illness, I try to convince myself. It’s not really her. But I’m afraid I know better. For the next couple of weeks, I show up early each Tuesday and Thursday to help her prepare for our date with Carl. Each time, it’s like starting from scratch. I have to talk her into going and remind her several times who he is and why we are getting together with him. When we arrive at Starbucks, the conversation between them is always the same, a virtual word-for-word replay of that first one. But the third Thursday is different. I get to her house an hour early as usual. When she answers the door, I do a double take. She’s all made up, dressed, and ready to go. 86 “Wow, Mom, you’re ready!” What was that I said before about subtlety? Maybe it’s catching. There is a glint of my real mom in her eyes, the one who enjoyed the attention of men and was a bit flirty with them. “We are going to see Carl, no?” She remembers Carl’s name! I watch as she reaches for her lipstick. She pulls off the cap and nods at the pale coral hue as it emerges from the tube. A relief—some days no color is right. She squints into the mirror, her forehead scrunching, as usual, at what she sees. She stretches her mouth into a distorted smile and, with a wobbly stroke, smoothes the tube over her lips, over the boundaries of where they end, making them as luscious and ripe as she wishes they were. She allows me to wipe off most of the excess. While I’m doing it, she takes a good look at me. “Why are you wearing your hair down in your face like that? You didn’t even comb it! And your shirt is too tight. You look like a prostitute!” She pushes my bangs back so they look like wings taking flight. Suddenly, it is my high school graduation day again. She doesn’t like my up-do; it’s “too old” for me. She yanks back all the carefully formed curls until my hair is flat against my head and winds it around in an old-fashioned French twist, securing it with bobby pins. My dress is “trashy” because a hint of whatever minimal cleavage I have is visible. She hikes up the neckline of my gown and secures it with a safety pin to make me “decent.” The knot in my throat screams. Tears burn behind my eyes, but I force them back. Now, thirty-five years later, my hand is clenched in the pocket of my slacks. It has formed a fist so hard that my fingernails are bending inward, digging into my palm for all they’re worth. Once again, I manage to keep it together. Thankfully, she loses interest in me and focuses again on herself. One final time she checks the mirror. I can hear her dentures clicking the way they do when she’s concentrating. The widow’s garb is gone. She is wearing a v-necked top that swoops down a couple of inches from her collarbone—downright scandalous for her. And it’s red—a deep rosy red, with little sparkling beads at the neckline. What’s more, she has found earrings that actually have flecks of crimson. And she is wearing a skirt. I haven’t seen her legs in months. And neither has she, apparently. Or more probably, she doesn’t care about the fine bits of skin that rest on the surface like coconut flakes. Months ago I gave up trying to get her to use lotion; you have to pick your battles. “Hurry up. We are going to be late,” she says, stealing my usual line. The conversation at the coffee shop follows the regular script. But this afternoon when Carl gets to the part about going out to dinner at that Northern Italian place, she says, “Yes, I would love to go!” I want to hug Carl. And I think maybe she does, too. Sunday, the day of the dinner with Carl, I call to remind her. Big mistake. God, I should know better. She absolutely can’t go. She has nothing to wear. I suggest outfits. No, she’s not going. I tell her I’m coming over to help her get ready. She starts yelling. “It is stupid for me to go. I don’t really know him. What if he does something bad to me?” “Like what?” “You know, what if he kidnaps me, takes me away someplace where no one can find me?” “Don’t worry. He’ll bring you right back in a hurry, I guarantee it.” “You are making of fun of me.” Her voice is getting louder. “I don’t really know him. And I am too old to go out with another man. What would your father say if he could see me… going out with Shirley’s husband?” “He would probably tell Carl to have a good, stiff drink before he picks you up and wish him good luck.” She hangs up on me. So I go over there, this time two hours before Carl is to pick her up. She’s a mess. I pull out a lovely green print dress, her favorite color. Ever fashion-conscious, she advises me that the shade is too bright for an o-o-o-ld lady like her. She stands “What would your father say if he could see me… in front of her closet and starts going out with Shirley’s going through the clothes, slapping one after another to the side, husband?” disgusted with their inability to measure up. I know how they feel. She is nearing the end of the rod now and with it the end of her patience. Her swing is gaining momentum, she is beating back each piece with the full force of her fist. Her face is twisted into an awful grimace, and tiny pools are forming in the corners of her eyes. 87 I grab one of the remaining dresses. Too late, I realize it’s green. “How about this? You wore this to the Senior Center the other day, and the ladies complimented you on it.” Miraculously, she forgets about her objection to the color, but she comes up with another obstacle. “I can’t wear this to the Senior Center twice in a row.” “You’re not going to the Senior Center. We’re going to church.” “Oh, it’s Sunday?” “Yes.” At least that part is true. It’s important at times like this to be flexible with the truth. We spend the next hour in the exhausting, slow motion ritual that used to take ten minutes. Finally, she is ready—at least as ready as she’ll ever be. Both of us are down to our last nerve when the doorbell rings. “Who is that?” She shoots a wild look from me to the door, then back at me. She reaches for one of her hands with the other and clutches it in a death “There are two things grip. There is nothing more terrifyI will not do for a man: ing than the unexpected. My way of dealing with it is cook and have sex!” unconventional. “Maybe it’s the fashion police, coming to make sure your outfit’s okay?” I know I’m pushing my luck, but we all cope in different ways. She sneaks up to the door, opens it just a crack, and flattens her eye in the space. “Carl! What a surprise!” Suddenly, she’s all cookies and cream, her face coloring as she lets him in. 88 After a few minutes of chatting, Carl says they have to be going because they have reservations in fifteen minutes. “Reservations? For what?” She says it with such alarm. He manages to calm her down, explaining again about the restaurant with the tiramisu. He helps her into her coat and pats her on the shoulder. With his broad, steady palm on her back, he steers her out the door. Just before she disappears, she turns back to me. “Honey, thank you so much for helping me. I don’t know what I would do without you!” And they are on their way. This time, the knot in my throat wins. A couple of hours later, Carl phones me to report that it went well and that he has just dropped her off. Immediately, I call her, to hear the story before it evaporates. “He-llo-o!” she answers, singing the word. Oh, yes, she had a wonderful time…the evening, Carl, the food—and again Carl. “So, you like him?” My mouth says it before I can stop it. I have so much to learn. Well, he’s okay. Not really her type. You know, she prefers men who are more handsome, thinner, with more hair, more distinguished. “See, you shouldn’t have turned down Cary Grant when he asked you out.” Plus, he has a moustache. “Did it tickle?” She’s appalled. “Maggie, we did not have sex! There are two things I will not do for a man: cook and have sex! I did not even have sex with your father!” I manage to jam my hand over my mouth just in time. Restraint is an important virtue in dealing with these types of pronouncements, one I need to practice a lot more. Just as I hoped, my mom and Carl fall into a comfortable rhythm, going out a few times a week. It’s a structured schedule: dinner on Sundays, coffee on Tuesdays, and ballroom dancing on Thursdays. Yes, dancing! I really lucked out with Carl. He loves to dance. One Thursday I stop by the Senior Center to watch. I stand by the door where they can’t see me. They are doing the Viennese Waltz, the real waltz, as my mother has informed me many times. She seems to coast above the floor, her feet sliding from one step to the next as though weightless. Her face is flushed, beaming. She’s back in the 1950s, a beautiful young woman, dancing in the arms of my father, oblivious to fate and time and what they have in store. That night I get a call from Carl. He would like to see me for coffee, just me. For the next two days I gnaw my cuticles and run through the probabilities…he’s had enough. I don’t blame him. I feel that way, too, all the time. He wants a raise. I should have thought about that sooner. He deserves one; he’s surpassed all expectations. By the time we meet, I’m prepared to give him more money, whatever. I’m prepared for anything—anything, except this. “I can’t do it anymore, Maggie.” “I know, it’s really hard. I can pay you more.” “No. You don’t understand.” His soft, brown eyes find mine. “I love her.” He tells me he can’t accept my money anymore. He would like to continue seeing her and seeing her more often. They understand each other. She is everything his wife was not: talkative, interested in him, well-traveled, and a charming companion. He doesn’t mind about her memory. Every experience is delightful because it is happening for the first time, and delight is something that’s hard to come by these days. But with her, it’s always there, and it’s rubbing off on him. But the constant repetition? Answering the same questions over and over? The confusion? Doesn’t that get to him? He shrugs his bear-like frame. He’s a patient man, he tells me. He can think of many other flaws that are a lot more annoying. His very presence is like a hug. I leave the coffee shop in He doesn’t mind about a daze. A fairy-tale ending her memory. Every was not in the script, not in experience is delightful any of the possibilities I had because it is happening for imagined. It doesn’t make the first time, and delight sense. It’s fishy. There must is something that’s hard to be another angle on this. I come by these days. struggle with the alternatives. He can’t be after her money, because she doesn’t have much, and he knows it. And it sure isn’t her cooking or the sex. So what else can it be? Unreal as it sounds, he must be for real. The unthinkable has happened. My little scheme to fool Alzheimer’s into remission has worked. In spades. A few days later, I stop at my mom’s. She’s all blushy and bustling, showing me the new dress she just bought, a 89 delicate, buttery yellow with a jewel neckline. “It’s for the senior prom at the Community Center,” she gushes. Just like the high school ones. It’s an annual dance, held in the spring, corsages and all, except the attendees are in their seventies, eighties, and even nineties. “I hope Paul likes it,” she says. “I’m sure he will.” I stop. “You mean Carl, right?” “No, Paul.” She is looking at her shoes with a coy smile. “Who’s Paul?” “I met him at Bingo. He’s very handsome. A real gentleman, too. I asked him to go to the prom with me. Can you imagine? When I was young I would never have had the courage to do something like that.” My thoughts are careening like crazy, but I force myself to sound calm. “What about Carl?” “Oh, you know, Carl isn’t really my type. I told him I couldn’t see him anymore.” Seconds go by, and I can’t think of anything to say. I feel like she’s just thrown freezing water on me…like when I was fifteen and it was her birthday. I had saved up money from my summer job to buy her a bracelet, “I asked him to go a really nice one. I spent two hours to the prom with me. in Macy’s picking it out. When I gave Can you imagine?” it to her, she asked where I bought it so she could exchange it. I froze just like now, but nothing compared with the way Carl feels, I’m sure. Sweet Carl. This is all my fault. I tried to re-route fate, and fate struck back big time. Who’s going to step in now and 90 change it for Carl? The least I can do is call him and apologize. She stops me when I get to the door. “Maggie…” I look back, and she’s there, my real mom. Her eyes are alive, and she’s wearing that smart-ass grin she used to lay on me all the time. “Thank you for introducing me to Carl, honey.” RIGHT: Paysaten Thistle John Voss 91 Dirty Poet 4:45 i could give him ten breathing treatments he’s still 84 years old struggling to breathe at 4:45 in the morning i could give him twenty treatments he still has CHF jamming the right chamber of his heart flooding his lungs he’s not drowning in it, not yet but every breath is a squat thrust i sit with him at 4:45 in the morning administering useless medicine watching ice truckers, shooting the shit it’s not lasix, which is what he needs to flush the fluid but i’m good company and so is he and that will have to be therapy enough at 4:45 in the morning A Little Soul Eleanor Leonne Bennett 92 93 Formation of Identity contest finalist—Prose Cecily Markham The Wishing Stone I walk into the room to check on her, to see if the pain medication helped. I am a young nurse. My patient is lying in the bed by the window. The room is honey-like from the sun pouring in. My patient’s husband is lying in the bed bedside her. He is talking to her, bringing memories into the small, intimate space they share, celebrating their life together. In this moment a truth is illuminated for me, a truth about pain and love in our most vulnerable hour. 94 He wanted to make the day timeless. To create it that way. He dreamed of rain with her. Dreamed of so much rain. He wanted her words; he wanted her to stay; he wanted her words. The way she didn’t speak, the way she spoke with words that would fall upon him, and move through him like a riderless horse on sun-washed plains, a beautiful ocean storm he wanted to be a part of, an indecisive wind that would howl and howl and pull back and take with it some part of him. He didn’t want to know where he was with her now or where she was, only memory, love, this holding her pale slender arms—timeless. If he could only make the shivers go away, he thought, to make her warm again. He reminded her of mountains they had hiked and little creeks they’d found and waterfalls with June sunbows and the long blue-green hills they had climbed on the way to the sun. He thought of the day they’d made love in the river before Sarah was born, and afterwards found a midnight-blue marbled stone along the bank that was smooth as still pond water. He remem- He spoke of all their children, spoke their names out loud—Sarah, Jason, and Patrick—so that the thinning air, so that time if there was any time, would not forget. He carried her with his own words through their gardens of foxgloves, azaleas, and English roses, and he reminded her how the poplar trees along the drive to their house sway and sing with unfettered music, beyond courage, beyond his strength and trembling, what is marrow and sacred—past all that is hardly human. She died that day lying next to him, slipping away on violet evening shadows, and some beginning stars, who whispered back to him, echoed to him soft as her silk blouses, soft as her rains, my song, my time was with you. The river would always know how to find them. bered how they rubbed it together and made a wish that the stone would remain there, holding the pulses of their fingertips inside, and that the river would always know where they were. The river would always know how to find them. remembrance, and waiting. Because he wanted to enter her wholly, past her human edge, all her river to sea, all her sky to sky to her invisible self, he kept holding her, lying next to her in the narrowing afternoon light that was losing its day—penetrating through him, 95 Carol Baldwin Why I Never Went to College I learned to use a cash register at age four. We had a family business, red apples, green apples, I could fall back on. I remember climbing the gnarled trees, picking the white blossoms, galloping through the orchards trying to get home to dinner on time: a good girl. In school we learned that numbers could never be divided by zero; this was because the teacher said so. A solid source of fiber, also vitamin A. Then you don’t ask questions. I was a silent teenager. I didn’t ask about parabolas. Infinity I understood: an unending supply of apples. We cored, pared and cut. I saw a psychiatrist. For checking too many times that the oven was off. For counting to fifty over and over in even numbers. For fearing I’d murder my family. Not even the Mafia had that much sin. Dr. Zeller prescribed pills that made me sleepy so I earned C’s and D’s. I picked apples year-round in my naps filling all the buckets in the root cellar making strudel for supper. RIGHT: Rosey Fingered Dawn Thomas Wright 96 97 Formation of Identity contest finalist—Poetry Monica Wendel Here’s the Dream Here’s the dream: that I’ve made the right choice. That everyone forgives me for everything. That we can sleep at night. That the dog I’m dog sitting never barks or snaps at me but instead curls up and is comforted by me. Here’s the dream: that I am a comfort to someone. A pin somewhere: “I’ll be codependent if you want me to be.” That I’m a good dancer. That I never do anything stupid while blacked out drunk. There I always come during intercourse. That I’m a better reader. That I write better book reviews. That I own a dog. That I know what it’s like to be pregnant. That I know what it feels like to have unprotected sex with ____. Here’s the dream: I’m in Park Slope and I’m trying to walk on cobblestones in high heels. I fall and both my ankles hurt. The stones are grey and eye level. I take out my phone to call the office and tell Dr. ____ that I’ll be late. My cell phone won’t turn on. I wake up. Here’s the dream: big stone walls like those next to the FDR drive on the east side of Manhattan. A museum there, that I’ve just emerged from, and a highway underneath that. Here’s the dream: I am outside a house, two or three stories tall, with columns. The man grabs me, stumbles, touches my breasts. I tell him to stop, stretch my arm out to push him away, drain my face of panic so he does not grow hard with my fear. Here’s the dream: he lowers his head, wraps me in his arms, kneels so both of us are low, breathes, ashamed, ashamed of what he has done, and comes to me for comfort. NYC Parking Murray Whitehill 98 99 Dan Sklar Of Time and the Beauty Contest Sally won a beauty contest on Salisbury Beach in 1952. Now, Ed takes her out summer nights to the gazebo in the park. One July night is like the summer night she won the beauty contest. Her hair is thick and white and sticking out. She doesn’t know who she is. She doesn’t know who Ed is, like the summer she won the beauty contest. Her granddaughter won the same contest in 2003, the same square jaw. Sally doesn’t know who she is. 100 Sally waves and smiles, asks the neighbors about their cat. Ed holds her hand pulling her along on the way to the gazebo. She stops and points to a bright star, the same one the night she won the beauty contest. RIGHT: Sea Turtle Teresa Guise 101 Susan Okie The New Patient Old man, in your loose shirt, with your hooded gaze that says, Look elsewhere, I see you. Or do I? Grasping your cane, clear eyes, white, fuzzy hair, there— but your edges blur, almost disappear. I ask, the more you look away. You’ve got a daughter in the city, once in a while she calls. You’re fine alone, have been for thirty years. Drink? Brandy, to sleep. You spread your fingers, showing me the depth of a good swig. In your eyes, On a desert road, I met a coyote, fur like a beaten rug, the color of drought. He never slowed and with a cold eye stared me down, daring me to watch him lope past. I looked away, walked fast. You’ve got his look, his camouflage coat. something reminds me of my father, how he’d fend off questions, would never let me in. You’re sicker than you know. I tick off blood tests, talking past you to the nurse who’ll call you, maybe get you to come back. But I can feel It’s your legs bringing you in: you have to throw a leg out sideways from the hip to take each step. How long has this been going on? Below the knees you’re numb, your heart is racing, ribs stick out like chicken wings. The more you weighing whether coming here was such a clever move. Better to turn off into the thorny scrub, blend in, pretend you never saw me. This road might lead to the rancher with the shotgun, not down to the stream under the sycamores. Dr. Who Overshoots the 60s Lance Buckley 102 103 Elizabeth Maria Naranjo The Distance Ratio It was a question that, in the beginning, struck me as rude and intrusive. But it passes the time. Besides, they never question why you ask; the right to dignity is something most have long since surrendered. “So how’d you get burned?” I slipped the pressure cuff over his emaciated upper arm, willing my fingers not to recoil from the slick, lifeless sheet of skin that covered it. “Walking home from my friend’s house. Some guys lit me on fire.” I looked up at him. He had warm, brown eyes too large for his sunken face. It was hard to guess his age, maybe 15, maybe 20. A kid, anyway. “Were you out drinking?” “Nah, playing video games at my buddy’s house. I was walking home when these gang members saw me, 104 thought I was in a rival gang or some shit. They poured gas on me and lit a match.” “Hmm,” I murmured, trying to look nonchalant while my stomach flipped. He knew better, this boy who had suffered second and third degree burns over sixty percent of his body was permanently disfigured and would spend many years undergoing painful surgeries. He pressed an unnaturally smooth, cold hand on my forearm and grinned. “I know man, it sucks. But check it out. The state? They said they’d pay for my college education.” It’s a story I thought I’d never tell. At a burn unit, the way to cope is to leave the stories there. Bring nothing home and take nothing in with you. But I’m lousy at my job. Each baby I hold could be my own, sheets of skin peeling off, rivers of blood pouring down her legs. They scream when they see someone in scrubs approach; I have to pry them away from their mothers. My daughter is seventeen months old. Her bright, dark eyes tell stories. Her mouth is a kiss. Before she was born, I counted by years. I’d worked in the hospital about a year. I’d moved to Colorado around three years ago. Then Sarah came and I began counting by weeks. Sarah’s one week old; it’s time for At a burn unit, the way to cope her first well-baby is to leave the check. Sarah’s three stories there. weeks old; the cord should be falling off. Sarah’s six weeks old, and she just smiled for the first time. When she was seven weeks old I returned to work and everyone became the enemy, intruders that stood between me and my daughter. I hated them: their petty complaints about traffic, their useless drama. Their world continued unaffected while my heart keened in my chest, wracked with guilt at abandoning my infant, not two months old and in a stranger’s care. If I had a decent job, I thought, I could have stayed home another month, or returned part-time, something. What else would my lack of education cost her? I needed a better job, a future. I applied to a fast-track nursing program and three months later received an acceptance letter. The program was intense, full-time. I would have to work graveyards and sleep when I could. The only opening was in the Burn Unit. “You won’t make it,” my co-workers said. “It’s brutal, awful. Highest turnaround in the hospital.” I put in for a transfer. After the first night, I printed out a nine-month calendar and circled the final day of school, the day I would come to see not as the beginning of my nursing career, but as the end of my time in the Burn Unit. And then I began counting by the day. ***** A man is slumped down in a tub filled with bloody water. I’m kneeling at the edge, holding a hand swollen twice its size, thick and bloated, the way I imagine a corpse would look. He may as well be a corpse. He is burned over sixty-five percent of his body, including most of his face, spends his days alternating between the tub room and sedated in bed. Using an instrument that resembles a scalpel, I begin to pick at the edges of dead skin on the man’s palm. “Uhnnn,” he protests, but he can barely open his eyes. His head rolls back. He is sedated to the point of unconsciousness. Although nothing can kill the pain completely, at least the Versed will wipe out his memory. The nurse pushes more of it through the catheter dangling from his arm, then frowns at me. “What are you doing?” “Debriding his hand.” “Do it faster.” I press harder, scraping the blade against the man’s flesh, chiseling away the necrotic tissue that falls away in clumps that sink in the water. Bursts of blood appear, like those fast-motion frames of blooming roses. “Good,” the nurse says. “Better.” She picks up her own debrider and begins to carve away his face. His cheek is Bursts of blood white and slick, appear, like those and she slices it fast-motion frames like she’s giving of blooming roses. him a shave. The man jerks, and his throat whistles in what he probably thinks is a scream. I know that the dead skin has to come off so the new skin can grow, and I know that the blood means life and should be beautiful like roses, and I know without lopping off pieces of the man’s flesh he’ll have to endure more surgery and that the surgery is worse. I know, I know, but my arm is numb, and I can’t cut that hard. I can’t. The nurse looms over me. She grabs the man’s hand and slashes down with blunt force. The skin I’d been picking at peels away like the skin of an apple. It slides into the tub. The nurse lets his 105 hand drop back in the water and glares at me. “You’d better learn to work faster. The IV meds have a short half-life. You know what that means, right? You’re in nursing school, right? Now get his wounds dressed.” I punch a hole in the plastic over the drain and the water and blood gurgle away. I drape clean wet towels over the man and, using the mechanical lift, position him in a chair. Section by section I remove the towels and replace them with gauze slathered with medicated cream. I love the smell of this cream, a smooth I know I’m not clean smell like equipped to deal its name: Silwith this much pain. vadene. At the end of each shift, I steal away to an empty room, turn the radio on, and prepare dressings for the next shift. I open a jar of Silvadene and, over a sterile field, I scoop out the cold cream and spread layers onto thin sheets of gauze. It’s like frosting a cake. I hum along to the radio and imagine I’m anywhere else. 106 When the man is dressed, I get him back in bed and return to the empty tub room. I gather the plastic lining, heavy with chunks of skin, and throw it away. I carefully sanitize the tub for my next patient, a girl of nine, whose flowing princess costume touched a candle flame and embraced her in fire. ***** My daughter is sleeping in my arms, her mouth open. I lean in and inhale the warm rush of sweet air, and my stomach seizes. I slip my arm out from under her and roll away, swinging my legs over the side of the bed and curling over my knees. What am I doing in nursing school? I will fail completely. I squeeze my eyes shut and the vision blurs, the trapped vision of the nurse glaring at me. “What are you doing?” she asks. Gathering myself, I slip from the room and go outside. I light a cigarette even though I quit years ago. I stare at the sliver of moon, but what I see is a silvery edge of fabric catching fire and the gleam of a metal blade and the slender arc of my daughter’s eyes, and I know I’m not equipped to deal with this much pain. Once when I was filling in as a receptionist in the emergency room, a woman burst through the doors and ran to the counter. “My daughter was in an accident, my daughter, can you tell me what’s happening, please, my daughter, car accident….” I stared open-mouthed, until someone nudged me and whispered, “Trauma Two, the five-year-old.” I closed my mouth and stared at the woman. Her daughter was dead. I knew this, but I couldn’t tell her; that was the doctor’s job. I told her instead to have a seat and he would be right with her. Her gaze calmed a little, and she walked toward a vending machine that dispensed watery lattes and cappuccinos. I knew she was thinking, if my child was dead, surely they would just tell me. The minutes ticked by, and she sat and held her shitty cup of coffee without drinking it, and I watched a thin drizzle of foam slide down her cup and melt into her jeans. I wondered how anyone could want to work in the emergency room or be a first responder. I couldn’t wait to get back to the lab where the traumas were faceless: tubes of blood labeled with anonymous-sounding names or pieces of tissue dropped into specimen cups and wrapped in biohazard bags. Papery clouds cross the moon, and I squeeze the end of my cigarette, twisting the embers away. They glow down to ash on the concrete and I rinse off the patio, toss the butt over the wall. Inside, I scrub away the stink of smoke and change clothes and crawl into bed. There’s so little time to sleep, but when I sleep and then wake it’s time to say goodbye again and go to class. So I watch her until I can’t keep my eyes open anymore, and I drift away on a silent apology for the weakness that I once thought was a strength—this crippling sense of love. ***** A burn takes forty-eight hours to fully reveal itself. It works under the surface in an inevitable journey with unknown effects, like a choice that’s been made. The nerves that sense pain are in the second layer of skin, so the deeper burns that destroy this layer are less painful than the shallow burns that leave the nerves intact. I wonder, what is the optimal ratio of distance? If I had to choose, would I choose pain or numbness? Tonight on my way back from a coffee break, I see a woman alone in the waiting room. She smiles at me, and I smile back. Most of the techs hate her; she’s difficult, she’s demanding, she refuses to let anyone debride her daughter unless she’s present, something discouraged so the child won’t associate trauma with the parents. A few nights before, I had bathed her daughter for the first time, filling a shallow pink basin with warm water and sitting the toddler inside. Next to the basin I’d lined a shelf with bottles of soap bubbles and brightly colored wands. Her mother blew bubbles through the wands while I soaked and peeled the girl’s skin. And when the she cried, her mother tickled her tummy until the cries turned to laughter. We discovered our babies were the same age, had the same light-up Maybe the sound princess shoes, will bring me closer and loved to home, to my girl. Elmo with the same obsessive attachment. The mother apologized for insisting on being in the tub room, and I assured her if it was my daughter nothing could keep me away. But tonight the mother had sent her husband instead, and looking at her I feel the weight of her heart in my chest. She had been cooking spaghetti, had turned to drain the boiling water and tripped over the toddler she had just seen across the room. “I couldn’t go in tonight,” she explains, looking straight ahead. “It’s okay.” “It’s never going to be over for her.” “It’ll get better.” 107 I take a sip of coffee and, to fill the silence, ask her if she has other babies. “She’s the only one.” Her eyes are bright but she doesn’t cry when she tells me she isn’t having more children. She can’t be more than twenty-five. I think of the children whose parents had purposely scalded them. I think of the three-year-old who last week had four of his toes removed and refuses to look at his feet. His mother has never been in to see him. “I hope you change your mind,” I say. “You’re a good mom.” She smiles again and I walk back through the double doors, thinking maybe if her daughter is still in the bath I can blow bubbles at her and hear her laughter. Maybe the sound will bring me closer to home, to my girl. The distance is what gets you through the nights. 108 Contributer’s Biographies ART Eleanor Leonne Bennett is an internationally award winning artist and the CIWEM Young Environmental Photographer of The Year in 2013. Her photography has been published in British Vogue and Harper’s Bazaar and is featured in Schiffer’s Contemporary Wildlife Art. Lance Buckley is best known as one half of the DoM Enterprise Reporting System comedy duo and lives in Waynesboro, Virginia. Bobbye Cohen is a retired UVA nurse, who now volunteers for UVA Hospital and Hospice of the Piedmont. Teresa Guise, an endocrinologist at the University of Indiana, is an expert in bone metabolism as well as underwater photography. Jim Hagan was chair of the studio art program at UVA. He sculpted in wood and clay, and when his wrists and hands wore out, he turned to photography. He was also interested in boats, especially kayaks—building them and paddling them. He died in September 2008. His doctor, Daniel M. Becker, is the founding editor of Hospital Drive and also one of Jim’s kayak students. Sharon Hostler is the McLemore Birdsong Professor of Pediatrics (Emeritus) and Semester-at-Sea Academic Dean at UVA who draws with her patients and grandchildren. Her essays have been published in Pharos and The Giant Squid, and her artwork in Permanente Journal. Elizabeth Meade Howard, a former lecturer at UVA, now serves as art editor for Streetlight. She has recently finished writing Aging Famously: Follow Those You Admire to Living Long and Well, a collection of interviews on the importance of elder mentors and role models for successful aging. Armando Huaringa is a Critical Care doctor in Los Angeles. He was given his first camera as a birthday present from his grandmother. Harrison O’Connor has painted thirteen paintings and is the Grandma Moses of central Montana cattle ranchers. John Voss photographs the landscape using both old-fashioned large format film and the latest digital media. He is a general internist and the Vice-Chair for Quality and Safety in the Department of Medicine at UVA. Murray Whitehill is a photographer currently living in Wilmington, NC. He moved there in 2013 from Charlottesville, Virginia where he remains a member of the McGuffey Art Center. 109 Kenneth Weinberg is a board certified Emergency Physician, working in a community hospital in the NYC suburbs. In addition to photography he also writes stories, fiction and creative nonfiction, which have been published and broadcast on radio. Thomas M. Wright, was a retired surgeon whose neurologist suggested that he submit work to Hospital Drive. Dr. Wright has passed away since his work was published in 2009. POETRY Michael Adams is the author of nine books of poetry and essays. His poem appeared in Issue Ten of Hospital Drive. Since its publication in 2013, Michael has passed away. Carol Baldwin’s poems have been published in Snapdragon Journal, Anderbo, The Dos Passos Review, Evening Street Review, Mistletoe Madness, and other publications. 110 Barbara Brooks is the author of The Catbird Sang and A Shell to Return to the Sea chapbooks and is a member of Poet Fools. She currently lives in North Carolina. Kathleen Cain was a long-time contributor and editor for The Bloomsbury Review. She is the author of the nonfiction book The Cottonwood Tree: An American Champion. The Dirty Poet has a book, Emergency Room Wrestling. Laura Foley is the author of four poetry collections, including The Glass Tree, which won the Foreword Book of the Year Award, and Joy Street, which won the Bi-Writer’s Award. Will Clemens teaches at several colleges in Ohio and is the editor of All Shook Up: Collected Poems about Elvis. Graham Fulton lives in Paisley in Scotland. His most recent books of poetry include One Day in the Life of Jimmy Denisovich, Photographing Ghosts, Continue, and Brian Wilson in Swansea Bus Station. The poem “Equinox” is part of a collection called Equal Night, which is being produced by Irish publisher Salmon Poetry in 2017. Steve Cushman’s debut novel, Portisville, was the winner of the Novello Literary Award. His poetry chapbook, Hospital Work, detailed his years working as an X-ray technician. A new novel, Hopscotch, will be released in the fall of 2016. Courtney Hartnett is currently a lecturer in the English Department at UNC-Greensboro. Her poems and prose have appeared or are forthcoming in Gertrude, Bombay Gin, Appalachian Journal, storySouth, and elsewhere. John Casey is a novelist and professor of English at UVA. Michael Harty is a psychologist and psychoanalyst and author of the chapbook The Statue Game. Anjali Jain is a pediatrician and health researcher, and a writer of poems and essays. Her work has been published in Health Affairs, Academic Pediatrics, and NPR. Martha Kaplan is a Pushcartnominated poet, and winner of the Dr. Zelda Mapp Robinson International Poetry award from Möbius, the Poetry Magazine. Timothy Kelly has authored poetry collections, including Stronger and The Extremities both from Oberlin College Press, and, most recently, Toccata & Fugue from Floating Bridge Press. He is a physical therapist whose writing revolves around his work with bodies. Kendra Kopelke is the author of three books of poems, including Hopper’s Women. She co-edits Passager Books and Passager journal and directs the MFA in Creative Writing & Publishing Arts at the University of Baltimore. John Krumberger is the author of a poetry collection, The Language of Rain and Wind, and a chapbook, In a Jar Somewhere. His latest collection, Because Autumn, will be published by Main Street Rag Press in 2016. Sandra Lapham is a distinguished fellow of the American Society of Addiction Medicine. She has published on the topics of epidemiology, screening, and treatment of substance use disorders and has authored more than 100 peer-reviewed publications in the public health field. Kristin Laurel is employed as an ER nurse and flight nurse. Her first book, Giving Them All Away, won the 2011 Sinclair Poetry Prize from Evening Street Press. Beverly Magovern Lyon has been a storywriter for many years, telling tales of family, health, and resilience. Mary Richardson Miller is a painter, photographer, and poet living in Bucks County, Pennsylvania. Dave Morrison’s seventh book is Clubland (Fighting Cock Press), a collection of poems about rock bars written in verse. Barry W. North is a seventy-one-yearold retired refrigeration mechanic. He lives with his wife, Diane, in Hahnville, Louisiana. His published chapbooks are Along the Highway, Terminally Human, and In the Maze. Dianne Nelson Oberhansly’s book of stories, A Brief History of Male Nudes in America, won the Flannery O’Connor Award. Her latest book, The Madonna of Starbucks: Stories, Poems and Essays on Food, will be published this spring. Susan Okie is a physician and former Washington Post medical reporter and science editor. Her work has appeared in The Gettysburg Review, The Bellevue Literary Review, the Journal of the 111 American Medical Association, Passager, and Beltway Poetry Quarterly. author of two chapbooks, Pioneer and Call It a Window. Renée Rossi has published two poetry chapbooks: Still Life, winner of the 2009 Gertrude Press Chapbook Prize in poetry, and Third Worlds. PROSE Elizabeth Maria Naranjo’s fiction has twice been nominated for a Pushcart Prize. Her debut novel, The Fourth Wall, was released in June 2014. Linda Chase is author of the novel Perfect Cover and of several books on contemporary art. “He Was Henry Hudson” is an excerpt from a memoir in progress, which chronicles her husband’s 1999 stroke and subsequent recovery. Rebecca Previs attended UVA for medical school and Duke University School of Medicine for her residency in obstetrics and gynecology. She is now a third year fellow in gynecologic oncology at The University of Texas MD Anderson Cancer Center. Marianna Crane has been a nurse for more than forty years. Her work has appeared in The Eno River Literary Journal, Examined Life Journal, and the New York Times. Marsha Roberts has short stories and essays in Thrice Fiction, Gravel, Loud Zoo, Biostories, The Marin Independent Journal, and America’s Funniest Humor Showcase, among others. She has just completed her first novel, The Agent, about an elegant con game. Johanna Shapiro is professor of family medicine and director of the Program in Medical Humanities & Arts at the University of California at Irvine School of Medicine. She is co-editor for the e-magazine Pulse: Voices from the Heart of Medicine and the journal Families, Systems, and Health. Dan Sklar teaches creative writing at Endicott College and has poems in the Harvard Review, The English Journal, and The New York Quarterly, among others. Monica Wendel is an assistant professor at St. Thomas Aquinas College and is the author of No Apocalypse, which was the winner of the Georgetown Review Press Poetry Prize. She is also the 112 Cecily Markham is a nurse, poet, artist, and integrated arts educator. Her collection of poetry, Sisters in Rain, won the 7th Annual Women’s Words Award and was published by Still Waters Poetry Press. New Rothko Kenneth Weinberg 113 $5.00 ISBN 978-0-692-62799-0 50500> 9 780692 627990 For more Hospital Drive throughout the year, visit news.med.virginia.edu/hospitaldrive